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Care Management Representative (RN)
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$56.5 an hour
Full-time
- Coordinates follow up appointments with patient's Primary Care Physician /Patient Center Medical Home/ Health Home based on risk status.
- Strives to incorporate the philosophy and mission of the hospital and its goals of rendering quality care management services.
- Care Management average patient case load is 20-25 pts:1 care manager and may have assistance with other team members such as social workers on dual plans and nursing facility placements.
- Completes CM assessments and LACE tool readmission risk determinations for identified patients such as those with chronic disease (CHF, RF, COPD, MI, PN & DM as well as those previously re-admitted or identified at risk patients) 2.
- Utilizes MCG- Milliman criteria to identify severity of illness & intensity of service for appropriate utilization management and 1st level criteria reviews.
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