Pacer Staffing LLC

Case Manager

Pacer Staffing LLC United States
Pacer Staffing LLC

Case Manager

Pacer Staffing LLC United States
1 month ago 33 applicants

See who Pacer Staffing LLC has hired for this role

Job Tittle: Case Manager

Location: Remote

Duration: 3 Months Contract

Shift: 8AM – 5PM (Mon-Fri) (CST)

Position Purpose:

  • Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.

Note:

  • Compact licensure is needed.
  • CA and OR RN licensures would also be a benefit if the candidate has those.
  • To further explain, my case management team is a specialty team.
  • Our focus is calling Medicare members all over the US within 30 days from a hospital, rehab, or any other inpatient stay to follow up on any pending needs they have and to review their most recent medication changes following the discharge.
  • We then send a medication reconciliation to their PCP via fax.
  • All work is done remotely, Mon-Fri, 8a-5p. It is call after call, so I need someone that is willing to make quite a few calls each day.

Walk me through the day-to-day responsibilities of this the role and a description of the project (Outside of Workday JD):

  • Outreach members by phone to review their needs following recent discharge, and to complete a medication reconciliation.
  • Outreach PCP offices to obtain a verbal medication list to complete a medication reconciliation on an unable to reach member.
  • Refer members to traditional CM teams as needed.
  • Complete a Transition of Care Assessment with member via phone calls.
  • Outreach members in different time zones throughout the US, from east coast to west coast.
  • Describe the performance expectations/metrics for this individual and their team:
  • Assignment to include 20-30 tasks per day; minimum of eleven successful TOC/MRP assessments per day; audits of 90% or higher.
  • Tell me about what their first day looks like:
  • System specific training to learn the navigation of the system and where to document the information.
  • What previous job titles or background work will be in this role?
  • Previous experience as a telephonic CM.
  • Other experiences that would benefit include Home Health, ER/triage, Case Management, and adult care.

Position Purpose:

  • Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
  • Develop, assess, and adjust, as necessary, the care plan and promote desired outcome.
  • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short- and long-term goals, treatment, and provider options.
  • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio-economic needs of clients.
  • Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs.
  • Provide patient and provider education.
  • Facilitate members’ access to community-based services.
  • Monitor referrals made to community-based organizations, medical care, and other services to support the members’ overall care management plan.
  • Actively participate in integrated team care management rounds.
  • Identify related risk management quality concerns and report these scenarios to the appropriate resources.
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems Qualifications.

Education/Experience:

  • Graduate from an Accredited School of Nursing.
  • Bachelor’s degree in nursing preferred. 2+ years of pediatric clinical nursing experience in a clinical, acute care, or community setting.
  • Knowledge of healthcare and managed care preferred.
  • Prior experience working in a remote role preferred.
  • Prior case management experience preferred, and Bilingual in Spanish and English is preferred.

  • Seniority level

    Mid-Senior level

  • Employment type

    Contract

  • Job function

    Other

  • Industries

    Staffing and Recruiting

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