Care Manager: Patient-Centered Care & Transitions Lead

Council on Aging (COA); Blue Ash (OH); On-site; USD 55,000 - 70,000; Full time

Job summary

Council on Aging (COA) in Blue Ash, Ohio, is seeking a Care Manager to provide intake, assessment, and ongoing care management for clients and caregivers. This role emphasizes patient-centered planning and collaboration with the care team.

The position focuses on developing care plans, coordinating services, and ensuring HIPAA compliance to protect client information. Home visits and out-of-office outreach support independence and better outcomes.

Responsibilities

• Develop, assess, and adjust the patient-centered care plan with measurable goals.
• Conduct advanced care planning with client and others involved.
• Discharge planning after ER visits, hospitalizations, and nursing facility stays.
• Manage transitions between care settings (long-term, community-based, and assisted living).
• Provide support/education to clients with complex medical/psychosocial issues.
• Conduct home visits and required phone contacts per schedule.
• Empower clients and caregivers to access health and community resources.
• Coach and support independence in lifestyle choices.
• Collaborate with interdisciplinary care team to ensure holistic care.
• Ensure HIPAA compliance and maintain confidentiality.

Skills

Care coordination

Interdisciplinary teamwork

HIPAA compliance

Job description

Council on Aging (COA) in Blue Ash, Ohio, is seeking a Care Manager to provide intake, assessment, and ongoing care management for clients and caregivers. This role emphasizes patient-centered planning and collaboration with the care team.

The position focuses on developing care plans, coordinating services, and ensuring HIPAA compliance to protect client information. Home visits and out-of-office outreach support independence and better outcomes.