Licensed Care Manager Home First

PruittHealth; Rome (GA); On-site; USD 65,000 - 85,000; Full time

Job summary

PruittHealth is seeking a Licensed Care Manager Home First to screen referrals, coordinate admissions, and work with providers to reconcile billing. The role requires an LPN license and a valid driver’s license, with travel using your own vehicle in the Rome, GA area.

You will partner with Medical Directors, home health agencies, and PCPs to ensure timely, high-quality care for members, completing paperwork, assessments, and visits as needed.

Qualifications

• Current State License as a Licensed Practical Nurse (LPN).
• Valid driver's license and auto liability insurance.
• Graduate of an accredited nursing program.

Responsibilities

• Markets area for awareness of SOURCE and PRN meetings with new PCPs.
• Completes all new admission paperwork and in-home assessments.
• Participates in weekly team meetings with Medical Director 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 home 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.
• 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.

Skills

LPN license

Driver's license

Auto insurance liability

Education

Graduate of a state approved accredited nursing school

Job description

Job Description - Licensed Care Manager Home First (2610178)

Licensed Care Manager Home First - 2610178

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

TRAINING, SKILLS, AND EXPERIENCE REQUIREMENTS:

Current State License as a Licensed Practical Nurse, LPN

Must have a valid driver’s license and automobile insurance liability

Graduate of a state approved accredited nursing school

Family Makes Us Stronger. Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference.

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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For more information regarding Florida’s Care Provider Background Screening Clearinghouse Education and Awareness, please visit https://info.flclearinghouse.com