What are the responsibilities and job description for the TRANSITIONAL CARE MANAGER position at Innovacare Health?
InnovaCare Management Services Company, LLC
InnovaCare Health is a dynamic physician lead healthcare provider pioneering change in value-based healthcare. We operate 40 clinics with 1,100 employees who share the mission, vision, and values that drive success in each of the communities we touch. Our goal isn't just healthcare; it's about promoting work-life balance and supporting the personal and professional goals of each employee to help them lead their best lives.
We are an organization strengthened by our diversity and inclusion. We strive to make an impact in the community through public health education, outreach, and our philanthropic endeavors that span beyond the doors of our facilities.
As we continue to grow, we want employees, like you, who value improving the lives of those they care for each day. #WeAreInnovaCare
Our practices offer : Women's Health, Wellness, X-Ray / Ultrasound, Dental, Chiropractic, Urgent Care, Managed Care, and Workers Comp services
Job Summary
The Care Manager (CM) position is responsible for promoting patient quality of care and cost-effective outcomes by the process of assessment, planning, facilitation, care coordination, and the evaluation of comprehensive health needs. The CM position collaborates with clinical staff inside and outside of the InnovaCare organization and the contracted insurance companies.
Essential Job Functions
Utilize clinical tools, data, and other information to complete patient needs.
Create individualized and comprehensive needs assessment for care management and treatment plans.
Document all treatment plans, tasks, and actions into EMR when applicable to meet turnaround times as documented in policy and procedures.
Collaborate with Utilization Management (UM) staff in transition of care protocols to avoid readmissions and focus on meeting all CMS STAR measures for transition of care (TOC) and Medication Reconciliation.
Clearly validate prescribed treatments and treatment plans to patients to follow.
Educate patients on available support services : social work programs, insurance company services and benefits along with other community resources to meet social determinates of health (SDOH) needs.
Collaborate with patients, providers, and insurance companies for successful healthcare outcomes and to manage chronic and high-risk conditions.
Document accurately complex medical information that outlines and demonstrates how to improve health results along with educating patients on Advanced Directives.
Responsible for on-going monitoring and evaluation of patients.
Follow care and quality management processes in compliance with regulatory guidelines and company procedures.
General Knowledge / Skills
- Must : Critical thinking and problem-solving skills.
- Preferred : Clinical knowledge of chronic conditions, management of high-risk patient populations and knowledge of available community resources.
- Strong knowledge of managed care concepts.
- Strong written and verbal skills with patients, physicians and other stakeholders including techniques in facilitating patient engagement in their healthcare.
- Demonstrate ability to timely assess and respond to patient and family needs.
- General knowledge of care (case) management practices, including familiarity with Medicare Advantage products, programs, and services.
- Experience in establishing professional and collaborative relationships with patients, providers, and insurance organizations.
- Basic computer skills, including working knowledge of the Microsoft Office suite.
- Not required, but preferred : Certification as a diabetes educator, nutritionist or social worker or other specialty.
Minimum Required Education, Experience & Skills
ENVIRONMENTAL AND WORKING CONDITIONS
In this position, the employee will work in an office setting that requires sitting, walking, talking, and listening. Position will require a valid driver's license and will travel approximately 30% of time.
Physical & Mental Requirements : (check all that apply)
The information listed above is not comprehensive of all duties / responsibilities performed. This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.
