Work telephonically and in the field with patients identified as high risk to identify needs, set goals and implement action steps towards achieving goals. Empower patients to help them improve their quality of life.
In this role, you will performs Case Management activities to assure medical necessity of admissions and appropriateness of continued stay utilizing the Interqual Criteria guidelines. Monitors the utilization of resources of all patients reviewed.
Perform duties related to the day to day operations of the Integrated Case Management functions to include working with members identified as high risk to identify needs and goals to achieve empowerment and improved quality of life for both behavioral and physical health issues.
Responsible for developing care plans in partnership with patients, monitoring ongoing symptoms, building continuity of care, reviewing patients claims data, laboratory reports, and prescriptions, engaging with patients to manage their own health, and working with patients and providers to set treat-to-target goals.
The Ryan White Medical Case Manager, Broward County Ryan White is responsible for projecting and integrating the Mission and Core Values of the AIDS Healthcare Foundation (AHF) in the provision of quality medical case management services to AHF Healthcare center Ryan White eligible patients.
Responsible for the delivery of skilled nursing care and supportive services within the scope of the nurse's education and experience. Compliance with Heartland Corporate Standards and local, state, and federal laws, in an institutional setting, within the policies of the institution. Supplements nursing care of clients.
Develops patient care plans based upon the assessment of the patients' care needs and provides ongoing monitoring of assigned patient case load through the duration of the program. Maintains client records by reviewing case notes, logging events and progress.
Manages one-time task assignment or full field case management referral to meet with attending physician, injured worker and/or employer to clarify medical and/or vocational claim related information which could not be obtained through correspondence or telephonic attempts by claims team.
You will perform duties to conduct and manage the day to day operations of the case management functions communicating with departmental and plan administrative staff to facilitate daily department functions.
The RN Case Manager utilizes a collaborative process of assessment, planning, implementation and evaluation, to engage, educate, and promote/influence members decisions related to achieving and maintaining optimal health status for our Americas International membership.