PruittHealth

Manager

• Responsible for the oversight of clinical care management of community based long-term care population for PruittHealth Premier Dual Eligible Special Needs Plan (DSNP).
• Advise and coordinate clinical care across the health care continuum of both community based clinical providers as well as social support programs.
• Assist patients to achieve optimal health status utilizing the most cost-effective quality resources.
• Conduct in-home and telephonic assessment and data collection with patients and caregivers and document findings.
• Develop a case management care plan for each patient based on thorough history and clinical record review.
• Monitor the needs of patients and families on an ongoing basis.
• Provide care management and coordination to assure patient progress through the continuum of care.
• Coordinate hospital activities concerned with case management and discharge planning.
• Ensure the scheduling, coordination and completion of the inter-disciplinary team with primary care provider.

RN Case Manager

• Provide clinical oversight over all patient care services and staff providing care treatment and services to patients
• Implement employee relations practices necessary to establish positive partner-partner relationships and promote a high level of partner morale
• Provide oversight coordinating referrals to the agency with internal and external referral sources
• Screen patient referrals for appropriateness for admission
• Evaluate the agency’s ability to meet the anticipated clinical needs of patients prior to accepting the admission
• Provide oversight related to making patient and partner assignments
• Assure the development, implementation, and updates of the patient’s individualized plan of care
• Provide oversight regarding all aspects of coordination of patient care delivery
• Assure that patient needs are continually assessed
• Honor patients/residents’ rights to fair and equitable treatment, self-determination, individuality, privacy, property and civil rights, including the right to wage complaints
• Participate in center/agency surveys (Licensure / JCAHO) and any subsequently required reports
• Maintain operations daily workflow by timely completion of tasks assigned to this role
• Utilize reporting capability for key indicators within HCHB and Strategic Healthcare Partner to achieve desired outcomes for patients, billing and financial success
• Collaborate with other key partners within organization to achieve agency clinical operational and financial success
• Coach, mentor and serve as a preceptor to clinical partners to achieve positive morale and retention objectives

RN Case Manager

Regional RN Clinical Manager – Home Health