Care Manager RN
| Company | Alternate Solutions Health Network |
|---|---|
| Location | Ohio, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Mid Level |
Requirements
- Registered Nurse licensure required
- Demonstrates exceptional collaboration skills
- Self-starter and innovative problem solver
- Knowledge of Medicare, Medicaid and all State/Federal guidelines for compliance of patient clinical care
- Strong clinical acumen to thoroughly understand the patient’s health and functional status and foster effective communication
- Able to create positive impressions and communicate effectively with a variety of people and personalities
- Is an active listener and demonstrates ability to engage care team in the patient plan of care
- Must project a professional image during virtual communication
- Ability to set up work systems and engage in flexible problem-solving behavior
- Observant and detail oriented
- Proficient in Microsoft Office including Excel, Outlook, Power Point and Word
Responsibilities
- Plan of Care (POC) review and revision to reflect accuracy and regulatory standards
- Recertification/Discharge review and recommendation
- Utilization/Calendar Management
- Adhere to Utilization Management Guidelines
- Participate in Interdisciplinary Team Meetings and Agency Townhall Meetings
- Seek opportunities to contain cost
- Review Charts to monitor compliance with regulatory and governmental regulations
- Meets productivity standards and workflow expectations
- Functions as a resource for clinicians, agency staff, and internal staff
- Collaborates with clinicians as necessary for documentation clarification or educational opportunities
- Attends in-service trainings and mandatory agency meetings
- Stays current with CMS guidelines and Oasis Guidelines
- Read and adhere to all Agency Policies and Procedures and follow Employee Handbook Guidelines
- Completes and submits all required documentation within specified company requirements
- Other duties as assigned
Preferred Qualifications
- Two years home care field experience preferred
- One-year clinical review preferred
- Two years case management and/or utilization management experience preferred
- Proficiency in HCHB preferred