Offer summary

Qualifications:

Bachelor's degree in nursing, social work, or a related field is preferred., Experience in case management or care coordination is essential., Strong communication and interpersonal skills are required to work with patients and healthcare providers., Knowledge of healthcare systems and patient care processes is important..

Key responsibilities:

Manage quality, cost-effective care using selective benefits tailored to members' needs.

Collaborate in the patient care process to assess and coordinate services for health needs.

Implement and revise comprehensive clinical case management plans for patients.

Conduct reviews with healthcare facilities to determine the need for continued care.

Job description

Job Description Summary

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With nearly 30 years of experience in providing advanced primary care, Carelon APC delivers exceptional patient experiences. Compassionate clinicians take the time to understand each patient’s unique health needs while also removing barriers to access. Patients trust us to receive the right personalized care where and when they need it – in our care centers, at home or virtually – to improve their health outcomes and quality of life.

Manage quality, cost-effective care using selective benefits and alternative services best suited for the member. Collaborate in a patient care process to assess, plan, facilitate, coordinate, monitor, and evaluate options and services to meet members' health needs

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How will you make an impact & Requirements

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CareMore Care Manager

Responsibilities:

Manage quality, cost-effective care using selective benefits and alternative services best suited for the member.
Collaborate in a patient care process to assess, plan, facilitate, coordinate, monitor, and evaluate options and services to meet members' health needs.
Support members or their representatives regarding care, care transitions, and changes in health status.
Implement a comprehensive clinical case management plan for each patient.
Obtain input from providers, patients, and families as appropriate, and evaluate and revise the plan as needed.
Analyze patient variances from the plan and initiate appropriate steps to resolve variances.
Develop and implement discharge planning for patients in conjunction with hospital-based case managers.
Perform telephonic, fax, and/or on-site reviews with skilled nursing facilities, home health agencies, or other contracted service agencies to determine the need for continued care.
Work closely with healthcare providers, families, and community resources.