LVN Case Manager

Responsibilities

• Direct patients to timely, appropriate healthcare services based on symptoms and medical conditions via phone.
• Provide Case Management services to GMG capitated patients focusing on high-risk patients for frequent inpatient or ER encounters, and patients needing added expertise.
• Appoint patients with GMG Providers, direct to Urgent Care or Emergency Room as needed, and provide standard or specific patient advice.
• Follow approved triage protocol guidelines set forth by the organization.
• Maintain an accurate database of GMG High Risk patients and review High Risk census weekly to reflect appropriate patients.
• Stratify patients in team meetings to define care needs and frequency for home visits by High-Risk nurses or licensed Social Workers.
• Place timely calls to high-risk patients to assess health status, ensure treatment plans are carried out, perform teaching, and monitor outcomes.
• Arrange appropriate acute care and follow-up care with PCP, Intake, and other GMG Providers or Preferred Providers.
• Absorb and educate patients about the disease process, symptoms, treatments, and provider orders.
• Inform PCP, clinical, and high-risk care team members of pertinent findings/issues.
• Update daily hospital census and participate in physician communications to keep tabs on clinical picture/plan for patient.
• Ensure prompt Hospital Follow up appointments to help prevent readmission.
• Assess discharge status, level of understanding and compliance; monitor attendance/ follow up on 'no shows and cancellations.
• Attend Patient Care Committee and High-Risk Team meetings to provide follow-up case management and other special care needs.
• Assist with setting up complex services needed acutely: SNF, Custodial Care, Psychiatric services, IV treatments, etc.
• Review HH/DME forms and ensure services are authorized before provider's sign/fax.
• Document appropriately in GMG computer systems, high-risk database, and other associated systems.
• Successfully meet care coordination and nurse triage production goals.

Qualifications

• Accurately and timely perform all duties.
• Develop and maintain supportive, productive, and effective relationships with external and internal partners.
• Show excellent written and verbal communication skills.
• Show strong attention to detail and exceptional organizational skills.
• Maintain strict confidentiality of company, department, and patient information.