Manages the transition of assigned Post Acute patients from acute care setting to the skilled nursing facility and/or home setting utilizing face to face and telephonic outreach to accomplish the goals of the Post Acute Program. Care coordination and facilitation with hospital discharge planners, case managers and hospitalist to obtain Post Acute orders for engagement.
Promote the overall success of Population Health by effectively facilitating care and improving outcomes across all points of the health care continuum - preventive health and wellness, through chronic care management to end of life care.
Works in collaboration with the PI Coordinators and Director of Quality to collect data to reflect trends within the interprofessional care coordination meetings related to quality and outcomes of services.
In this role, the selected candidate will strategically manage a sales pipeline to create sales growth and maximize revenue opportunities. Routinely analyze pipeline coverage percentage and target, hit rate, and pipeline deal profile to ensure that pipeline supports achievement of monthly, quarterly and annual goals.
The Case Manager has daily responsibility for developing, authorizing, coordinating, and monitoring community-based services to an assigned number of frail elders. The process begins with a comprehensive needs assessment, completed as part of an interdisciplinary team.
Works to enhance the quality of patient management and satisfaction and promotes continuity of care and cost effectiveness through integration of the functions of case management, utilization review/management and discharge planning.