Job Description
Provides telephonic clinical care management services using evidence-based practices to ensure patients receive appropriate, high-quality care that allows them to remain safely in their homes or communities. Key Responsibilities
Meet Your Recruiter
Chris Mazzurco
Provides telephonic clinical care management services using evidence-based practices to ensure patients receive appropriate, high-quality care that allows them to remain safely in their homes or communities. Key Responsibilities
- Coordinate and oversee the delivery of benefits and services for assigned members.
- Complete comprehensive care management and disease-specific assessments.
- Make timely telephonic care management calls based on patient risk level.
- Resolve and coordinate complex member issues impacting care delivery.
- Provide health education and coaching to members and caregivers.
- Assess social determinants of health (SDoH) and coordinate care to address barriers.
- Identify member safety issues and connect to appropriate resources (therapy, DME, behavioral health, etc.).
- Ensure high-quality, cost-effective care aligned with evidence-based clinical guidelines.
- Advocate for members and caregivers to obtain needed health services.
- Promote adherence to physician treatment plans through education and support.
- Reduce inappropriate ER and hospital utilization by increasing access to preventive and primary care.
- Participate in interdisciplinary team (IDT) meetings and case discussions.
- Maintain confidentiality of all member information and ensure compliance with federal, state, and payor regulations.
- Must have working knowledge of Medicare and Medicaid programs.
Meet Your Recruiter
Chris Mazzurco
PALLIATIVE RN CARE MANAGER in new york at Unknown Company
- Typical pay
- $71,760–$120,640
For context, most registered nurses earn between $71,760–$120,640 a year according to Bureau of Labor Statistics wage data. What this particular role pays is set by the employer — check the description above.
This position is listed as full time and onsite.