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Senior Care Manager Transition of Care
| Company | Centene |
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| Location | Columbia, SC, USA |
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| Salary | $73800 – $132700 |
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| Type | Full-Time |
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| Degrees | Master’s |
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| Experience Level | Senior |
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Requirements
- Master’s degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing
- 4 – 6 years of related experience
- LISW, LCSW, LMSW, LMFT, LMHC, LPC, or RN required
Responsibilities
- Assesses, plans and implements all aspects of medical and supporting services across the continuum of care for post-discharge members
- Completes pre-admission and post-discharge medication reconciliation
- Evaluates the needs of the member by completing clinical post-discharge assessments for members transitioning from healthcare facilities
- Evaluates medication and performs reconciliation between pre-admit and post-discharge medications
- Develops a care/service plan and collaborates with discharge planners, providers, specialists, and interdisciplinary teams to support member transition and discharge needs
- Assesses member current health status, resource needs, services, and treatment plans and provides appropriate interventions
- Facilitates transition into care management service for member based on acuity level
- Provides or facilitates education and resource materials to members, authorized caregivers, and providers to promote wellness activities to improve overall member quality of care
- Facilitates services between Primary Care Physician (PCP), specialists, medical providers, and non-medical resources as necessary to meet the medical and socio-economic needs of members
- May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources
- Serves as a subject matter expert to staff for clinical and non-clinical questions or issues related to post hospital outreach for members
- May precept new hires and support building core skills and providing guidance through the onboarding process
- Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
- Provides feedback to leadership on opportunities to improve and enhance care and quality of delivery for members in a cost-effective manner
- Performs other duties as assigned
- Complies with all policies and standards
Preferred Qualifications
No preferred qualifications provided.
