RN Care Manager - New Haven County

ComplexCare Solutions Inc.
New Haven
Oct 07, 2016
Nov 03, 2016
Employer Type
Direct Employer
Employment Type
Full Time
Job Description:

Scope: A member of the professional care management team who provides care management services to an assigned caseload. Key Duties:Performs care management as trained by ComplexCare Solutions.Identifies and acts upon barriers to care by using appropriate community and CCS resources including but not limited to, social workers, DME, Homecare etc???Reduces hospitalization and readmission rates by utilizing care managementFollows CCS policies & procedures and best practices including but not limited to:Documentation-Assessments and reassessments of body systems, environment, social, behavioral, financial and functional abilitiesDischarge planningProductivity standards: CM may be scheduled for up to 30 visits per week(5-6 visits per day)PHV visits within 48-72 hours of dischargeResponsible for enrollment assessments of assigned patients that includes evaluation of physiological, psychosocial, environmental, financial, and health-related behavior domainsEstablishes a plan of care with patients, providers, and payers that identifies and continuously reassesses cost-efficient appropriate levels of careEnhances communication and collaborative relationships with multidisciplinary healthcare team membersEmphasizes continuity of care, thus reducing or eliminating fragmentation, duplication, and gaps in treatment planActs as a patient advocate protecting privacy and confidentiality issuesProvides patient education, monitoring of health needs, and coordination of community resourcesPrevents adverse patient occurrences when possible and intervenes quickly if prevention is not possible, thereby minimizing poor outcomesFacilitates patient empowerment and quality of life by promoting educated, independent patient choice on all aspects of careCollects quality review data to support outcome measurementsMaintains a comprehensive working knowledge of community resources, payer requirements, and network services for target populationIdentifies opportunities for health promotion and illness preventionDemonstrates accountability for own professional practice by participating in educational programs that increase case management knowledge base and skill setParticipates in practice case studies Education/Experience Requirements:Registered Nurse with current state licensureMinimum of 5 years of experience in a case management, clinical or discharge planning role - one year minimum experience in case management preferredExperience with Medicare/Medicaid Skilled visits within last yearStrong professional level of knowledge and experience in the adult population and chronic disease managementMaintains current CPR certificationValid Driver License and carOASIS experience preferred within last yearHomecare experience required

Company Description:

ComplexCare Solutions is a healthcare organization that specializes in community based, care management. We care for the medically complex individual, providing an in-depth, personalized, comprehensive approach to support their health and well-being. Our goal is to keep the older adult, geriatric, Medicare member safely in their homes.