Licensed Care Manager Home First

Pruitthealth Corporation; Decatur (GA); On-site; USD 52,000 - 75,000; Full time

Job summary

Pruitthealth Corporation is seeking a Licensed Care Manager for Home First in Georgia. The role focuses on screening referrals, coordinating admissions, and aligning services with providers and billing processes. Outreach to community referral sources is part of the position.

The incumbent coordinates with medical teams, carries out in-home assessments, and ensures documentation and follow-up actions are completed. A valid RN license and CPR certification are required.

Qualifications

• Must hold a valid driver's license and auto insurance.
• Graduate of a state approved accredited nursing program.
• Certified in Basic Cardiopulmonary Resuscitation (CPR).

Responsibilities

• Markets area for awareness of SOURCE and PRN meetings with new PCPs.
• Completes all new admission paperwork for signed forms and in-home assessments.
• Participates in weekly team meetings and presents all new admits, annual assessments, hospitalizations, and discharges.
• Completes quarterly home visits and quarterly PCP visits with all requirements.
• Tracks hospital/ER visits, requests records, and communicates with hospitals.
• Coordinates with outpatient therapy centers, home health agencies, and rehab staff.
• Reevaluates member needs for service level and effectiveness; adjusts plans as needed.
• Attends trainings and trains new hires; participates in on-call rotation.

Skills

Valid driver's license

CPR certified

Registered Nurse degree

Education

State approved accredited nursing program

Job description

Job Description - Licensed Care Manager Home First (2610176)

Licensed Care Manager Home First - 2610176

Description

POSITION SUMMARY:

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

ESSENTIAL JOB FUNCTIONS, DUTIES, AND RESPONSIBILITIES:

• Markets their area for awareness of SOURCE and PRN meetings with new PCPs.
• Completes all new admission paperwork for signed forms and in-home assessments.
• Participates in team meetings with Medical Director each week and presents all new admits, annual assessments, hospitalizations, Home Health admits and discharges, repeat variances, People with potential for discharge and actual discharges and situations threatening someone’s health or functional status.
• Completes quarterly homes visits and quarterly PCP visits with all requirements for each completed.
• Completes variances at any given time when a care path goal is not met. Must list the variance plan of actions and must have follow up to resolution or a repeat variance with a new plan outlined. Tracks all hospital/ER visits by completing paperwork, requesting records and communicating with hospitals.
• Coordinates with outpatient therapy centers, home health agencies, healthcare centers (if short term), and rehab by working with their staff and completing skilled care track form. Makes PRN contacts and home visits if needed to assess member needs. Reevaluates member needs for service, level of service and evaluates service effectiveness.
• Uses own vehicle for travel. Completes mileage and time sheets for reimbursement. Arranges transportation as required. Is available for internal record audits as requested. Completes annual reassessments in member’s homes. Reviews medicine for appropriateness.
• Attends trainings when required. Trains new hires as needed. Is available for on-call rotation as designated by CMS referrals. Communicates with regulatory and DFACS agencies for APS and CPS referrals.

QUALIFICATIONS

• Must have a valid driver’s license and automobile insurance liability
• Graduate of a state approved accredited nursing school
• Certified in Basic Cardiopulmonary Resuscitation

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As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.

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