About this role
Job Title: Care Manager Department: Population Health Develops and initiates the Individual Care Plan, which is client-centered, com prehensive and consistent with program guidelines and policies and procedures Identifies, arranges for, and monitors appropriate community services based on a good knowledge of Medicare, Medicaid, and other entitlement programs Coordinate and facilitate patient care through assessment, evaluation, planning, and implementation Communicate patient needs to a variety of care team members and follow up accordingly Manage discharge plans upon completion of treatment Work collaboratively with patients, families, physicians, and nurses to ensure high quality care Act as the patient's advocate as it relates to insurance coverage and financial assistance Maintain the patient's comprehensive clinical record through detailed documentation Coordinate an interdisciplinary approach to support timely access to appropriate care, facilitate continuity of care among providers and improve utilization of appropriate resources Apply established principles of care transition and follow member through continuum of care as well as coordinate a warm hand-off to the appropriate provider and/or health plan for necessary involvement of continuation of care and services Assists UM Manager and participates in all internal and external audits Primary liaison with all contracted health plans for case management activities Ensure the privacy and security of PHI (Protected Health Information) as outlined in Medical Group/ MSO policies and procedures related to HIPAA compliance Other duties and special projects as assigned