Case Manager, Medicare Programs
Full Job Description
The Case Manager will be responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs and facilitate the members overall wellness. Most interventions will be telephonic. The Case Manager will identify members in need and provide education and care coordination to assist them in obtaining needed treatment while removing barriers to service.
This position is responsible for managing Medicare programs and beneficiaries assigned to ACO/MSO primary care provider partners/clients. The activities include but are not limited to:
Chronic Care Management (CCM)
High Risk Beneficiary Management
High-Utilization beneficiary management
Utilization Management and Transitional Care Management (TCM)
Enrolling patients into a case management program
Scheduling patients for Annual Wellness Visit
Preventive screenings and health maintenance information
Outbound calls for coordination of care (e.g. Specialists, Home Health, DME, caregivers, etc.)
ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES
Case Manager will be assigned to a population of Medicare beneficiaries
Case Manager will communicate with the Medicare beneficiaries and Providers for Care coordination
Ability to create and review care plans for assigned members as needed
Adheres to Medicare guidelines, quality, and compliance
Has basic knowledge of Physician offices dynamics and workflows.
Self-motivated and team player with work ethics and ability to assist in the growth and development of the Health Services team and the company.
Excellent organizational skills with the ability to manage multiple priorities
POSITION QUALIFICATIONS
Required: RN, LPN licensed in Florida or MA, CNA or other clinical backgrounds with relevant experience.
Preferred: 1 year of Case Management or Utilization management experience
Preferred: Experience with ACO, IPA, Medicare Advantage and/or physician practice
Must be comfortable working in a multi-cultural environment.
Willing to work full-time from office as this is not a remote position
Free of any barriers and distractions impacting assigned tasks
Must be fluent in English; Spanish-speaking a plus
Excellent observation, verbal, and written communication skills
Must be passionate, kind, and comfortable while communicating with seniors and clients
Job Type: Full-time
Expected hours: No more than 40 per week
Benefits:
401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance
Schedule:
Monday to Friday
Work Location: In person
Apply Now
The Case Manager will be responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs and facilitate the members overall wellness. Most interventions will be telephonic. The Case Manager will identify members in need and provide education and care coordination to assist them in obtaining needed treatment while removing barriers to service.
This position is responsible for managing Medicare programs and beneficiaries assigned to ACO/MSO primary care provider partners/clients. The activities include but are not limited to:
Chronic Care Management (CCM)
High Risk Beneficiary Management
High-Utilization beneficiary management
Utilization Management and Transitional Care Management (TCM)
Enrolling patients into a case management program
Scheduling patients for Annual Wellness Visit
Preventive screenings and health maintenance information
Outbound calls for coordination of care (e.g. Specialists, Home Health, DME, caregivers, etc.)
ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES
Case Manager will be assigned to a population of Medicare beneficiaries
Case Manager will communicate with the Medicare beneficiaries and Providers for Care coordination
Ability to create and review care plans for assigned members as needed
Adheres to Medicare guidelines, quality, and compliance
Has basic knowledge of Physician offices dynamics and workflows.
Self-motivated and team player with work ethics and ability to assist in the growth and development of the Health Services team and the company.
Excellent organizational skills with the ability to manage multiple priorities
POSITION QUALIFICATIONS
Required: RN, LPN licensed in Florida or MA, CNA or other clinical backgrounds with relevant experience.
Preferred: 1 year of Case Management or Utilization management experience
Preferred: Experience with ACO, IPA, Medicare Advantage and/or physician practice
Must be comfortable working in a multi-cultural environment.
Willing to work full-time from office as this is not a remote position
Free of any barriers and distractions impacting assigned tasks
Must be fluent in English; Spanish-speaking a plus
Excellent observation, verbal, and written communication skills
Must be passionate, kind, and comfortable while communicating with seniors and clients
Job Type: Full-time
Expected hours: No more than 40 per week
Benefits:
401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance
Schedule:
Monday to Friday
Work Location: In person
Apply Now