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Population Health Care Manager - Transitions of Care Remote
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Full-time
Remote
- Duke Connected Care , a community-based, physician-led network, includes a group of doctors, hospitals and other healthcare providers who work together to deliver high-quality care to Medicare Fee-for-Service patients in Durham and itssurrounding areas.
- General Description of the Job Class The Population Health Care Manager is responsible for delivering clinical expertise to manage health care needs of specific patient populations across the continuum of care with a goal of improving patient health outcomes and reducing unnecessary utilization and cost.
- Transitional Care Management / care transition support inclusive of functions of placement into the right setting of care (e.g., skilled nursing, assisted living, home with caregiver support)
- Assistance with and completion of medication reconciliation, access, education, and adherence
- Maintains timely documentation of all care management activity in Maestro, and other documentation systems relevant to the position.
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