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Manager, Transitional Care RBE - RN License Required
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Full-time
- OSHâs Transitional Care program supports multidisciplinary care across facility-based care teams, OSH care teams, utilization management, care navigation, and patients and caregivers.
- Transitions performance management: Provide guidance and oversight to TCM cohort, including evaluating team performance in the areas of: clinical assessments and medical record review, inpatient and post-acute discharge planning, reconciling medication lists (RN only) on behalf of the primary care provider (PCP), creating readmission prevention plans, and scheduling post-discharge visits with the PCP
- Collaboration and communication with internal stakeholders: coordinating with internal stakeholders (e.g. care team, social work, behavioral health, utilization management, patient engagement, central telehealth, etc.)
- Adhere to CMS, state specific and NCQA compliance criteria as related to Transitions of Care.
- Certified Case Manager (CCM) or equivalent case management certification required, or willingness to obtain within 12 months of hire
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