Licensed Care Manager Home First

About the role

Screens appropriate referrals and coordinates the admission process. Coordinates services with providers and handles billing reconciliation. Provides outreach to community referral sources.

Responsibilities

• Markets the area to raise awareness of SOURCE and PRN meetings with new primary care providers (PCPs).
• Completes all new admission paperwork, including signed forms and in-home assessments.
• Participates in weekly team meetings with the Medical Director to present new admits, annual assessments, hospitalizations, Home Health admits and discharges, repeat variances, individuals with potential for discharge, actual discharges, and situations threatening someone’s health or functional status.
• Completes quarterly home visits and quarterly PCP visits, fulfilling all requirements for each.
• Completes variances whenever a care path goal is not met, including listing the variance plan of action and following up to resolution or submitting a repeat variance with a new plan.
• Tracks all hospital/ER visits by completing paperwork, requesting records, and communicating with hospitals.
• Coordinates with outpatient therapy centers, home health agencies, healthcare centers (for short-term care), and rehab facilities by working with their staff and completing skilled care track forms.
• Makes PRN contacts and conducts home visits as needed to assess member needs.
• Reevaluates member needs for service, level of service, and evaluates service effectiveness.
• Uses own vehicle for travel and completes mileage and time sheets for reimbursement.
• Arranges transportation as required.
• Available for internal record audits upon request.
• Completes annual reassessments in members’ homes and reviews medicine for appropriateness.
• Attends required trainings and trains new hires as needed.
• Available for on-call rotation as designated by CMS referrals.
• Communicates with regulatory and DFACS agencies for Adult Protective Services (APS) and Child Protective Services (CPS) referrals.

Requirements

• Valid driver’s license and automobile insurance liability.

Schedule

Full-time, 1st shift.

Location: PruittHealth - Rome, Georgia.