Provide support to medical, behavioral and social support staff to determine needs, eligibility, and services for members.
Conduct screening and risk assessment interventions per program guidelines
Identify special needs members through the completion of health screens and other resources.
Work with community outreach / member advocates to coordinate member care.
Educate providers and community resources on program components and available support services. Educate members with special needs to foster compliance with program and positively impact outcomes.
Assist with modification and management of care plans, medical consenter or caregiver, Department of Family and Protective Services (DFPS) caseworker and family, if applicable, as well as the managing physician.
Follow up with members / MD via telephone, completing Task assigned
Documenting the follow up and satisfaction on pending / received services.
Productivity is determined by outreaching to all effective members weekly and having clear and concise documentation.
Education :
Requires Graduate from an Accredited School of Nursing or a bachelor’s degree and 4–6 years of related experience
Requirements :
4–6 years of related experience
Home health experience
Required : RN - Registered Nurse - State Licensure and / or Compact State Licensure required
Resource Utilization Group (RUG) certification must be obtained within 90 days of hire required
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Rn Care Manager • Lubbock, TX, US
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