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Asa part of the Tenet and Catholic Health Initiatives family, Conifer Healthbrings 30 years of healthcare industry expertise to clients in more than 135local regions nationwide. We help our clients strengthen their financial andclinical performance, serve their communities and succeed at the business ofhealthcare. Conifer Health helps organizations transition from volume tovalue-based care, enhance the consumer and patient healthcare experience andimprove quality, cost and access to healthcare. Are you ready to be part of oursolutions? Welcome to the company thatgives you the resources and incentives to redefine healthcare services, with acompetitive benefits package and leadership to take your career to the nextstep!
TheCase Manager, under the direction of the Manager provides direction, identifieshealth and psychosocial issues of a select member population and assesses,plans, implements, coordinates monitors and evaluates services and outcomes toensure maximized health of the member. Assumes a leadership role within the interdisciplinarycare team to achieve optimal clinical and resource outcomes.
ESSENTIAL DUTIES ANDRESPONSIBILITIES
Include the following.Others may be assigned.
Identifiesissues relating to members' physical and mental wellbeing that affects healthstatus and works in collaboration with both the member and provider todetermine appropriate care for case management services.
Incollaboration with the member and PCP completes a comprehensive function needsassessment (CFNA) and develops an integrated Plan of Care (ICP) assessingshort-term and long-term needs.
Actsas a leader during interdisciplinary care team conferences to achieve optimalclinical and resource outcomes.
Interactscontinuously with member, family, physician(s) and other providers utilizingclinical knowledge and expertise to determine medical history and currentstatus. Assess the options for care including use of benefits and communityresources to update the care plan.
Maintainsand documents initial CFNA; designs ICP that is attainable and in theappropriate business application program.
Actsas a liaison between physician and member to alleviate potential issues thatcan interrupt care
Maintainscase load by identifying cases that are no longer high in intensity or servicesand closes them timely and appropriately.
Schedulesor facilitates scheduling appointments and follow-up services; requestsconsultation and diagnostic reports from network specialists; contacts membersto remind them about upcoming appointments and/or missed appointments.
Maintainsand promotes confidentiality of patient information and adheres to all HIPAAregulations
Participatesin monthly case studies in the Medical Services Department
Otherduties as assigned.
Toperform this job successfully, an individual must be able to perform eachessential duty satisfactorily. The requirements listed below are representativeof the knowledge, skill and/or ability required. Reasonable accommodations maybe made to enable individuals with disabilities to perform the essentialfunctions.
Include minimumeducation, technical training, and/or experience preferred to perform the job.
MinimumEducation: RN or LVN or LCSW / LICSW
Licensure: Licensure must be current and unrestricted inthe appropriate jurisdiction
PreferredEducation: BA or BS in Nursing, MSW in Social Work
2+years of experience in a clinical acute care position, preferably in homehealth, physicians office or public health
1to 3 years disease management, case management or formal patient educationexperience;
Include minimumcertification required to perform the job.
Licensuremust be current and unrestricted in the appropriate jurisdiction
Thephysical demands described here are representative of those that must be met byan employee to successfully perform the essential functions of this job. Reasonableaccommodations may be made to enable individuals with disabilities to performthe essential functions.
Thework environment characteristics described here are representative of those anemployee encounters while performing the essential functions of this job.Reasonable accommodations may be made to enable individuals with disabilitiesto perform the essential functions.
Employment practices will not be influenced or affected by an applicant s or employee s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
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