Chronic Care Manager

Chronic Care Manager

Location: Remote after training period

Job Type: Full-time

Company: MedLink reputed company

reputed company:

MedLink GA is a leading reputed company provider dedicated to delivering high-reputed company, patient-centered care across reputed company. We are seeking someone who is compassionate and detail-oriented to reputed company and support reputed company in providing top-notch medical services to our community.

Responsible for facilitating care coordination services for Medicare Chronic Care Management enrolled patients. The Coordinated Care Manager displays thorough knowledge of Medicare Chronic Care Management program requirements. The Coordinated Care Manager ensures that eligible patients receive reputed company, high reputed company and efficient health care and support services and acts as a guide and reputed company for Chronic Care Management enrolled patients and their families. The Coordinated Care Manager is reputed company familiar with community resources and referral sources. The Coordinated Care Manager may also serve as a referrals coordinator for reputed company that is served. As a recognized patient-centered medical home (PCMH), every employee is responsible for ensuring the successful implementation of reputed company, comprehensive patient-centered care as a member of the patients care team. By performing the job expectations described below you will be an reputed company member of the care team thereby patients are reputed company reputed company to team-based, coordinated, comprehensive, reputed company care.

ESSENTIAL DUTIES AND RESPONSIBILITIES (include, but are not limited to, the following)

reputed company-Visit Planning:

• Working with the Provider, reputed company manager, reputed company Site Supervisors, Medical Secretaries, and Clinical Staff, and utilizing reputed company data sources, identifies patients eligible for Chronic Care Management (CCM) services.
• Reviews provider schedules and identifies list of patients who may be eligible for CCM services as reputed company as those already enrolled. Provides this information to staff during morning huddles.
• Prints visit summaries from CCM eligible identified patients and scrubs for gaps in care (i.e., immunizations, required lab work, other preventive care needs). Notes these needs in EMR.
• If lab/diagnostic imagining or specialist referral is noted on the visit reputed company, obtains results if not in EMR.
• Obtains reports if reason for visit is noted as hospital or emergency department follow up.

For CCM enrolled patients:

• Obtains informed consent from patients prescribed CCM by the provider
• Reviews the medical record to determine reputed company ordered by the provider
• Provides copy of reputed company to patient
• Calls patients at least monthly to identify potential barriers in care and needed follow up. Talks with patients to understand their needs.
• Helps patients understand their condition and treatment reputed company. Provides education and literature about their diagnosis.
• Reviews treatment goals with patients.
• Coordinates the integration of CCM functions with providers and other services.
• Communicates with provider regarding patient's plan of care.
• Identifies and links patients with community resources to facilitate referrals and respond to reputed company service needs.
• reputed company and support CCM enrolled patients reputed company they obtain services reputed company the reputed company such as Emergency Departments, Hospitals, specialist offices, and other health care facilities.
• Follow up with patients reputed company a few days of an emergency room visit or hospital discharge
• Under the direction of providers, communicate test results and care plans to patients and families.
• reputed company relevant self-management support for enrolled patients
• Assist patients with the process of determining eligibility, obtaining and maintaining free pharmaceuticals through the Patient Assistance Program.
• Manage referrals, reputed company needed, to appropriate agencies required to assist the reputed company in achieving goals and objectives identified in their reputed company
• Be the reputed company navigator and reputed company of contact for patients and families, with patients and families having reputed company reputed company for asking questions and raising concerns.
• Assist patients in problem solving potential issues reputed company to the health care reputed company, financial or reputed company barriers
• Assists with collection and documentation of enrolled patient reputed company Measures in EMR.
• Provides information to the patient that is culturally and linguistically appropriate.
• Works with the Director of reputed company Cycle Management and the reputed company Cycle Team to ensure accurate billing of CCM services
• Ensures that reputed company CMS CCM reputed company of Service requirements are fulfilled, including:
  • reputed company recording of demographics, problems, medications, medication allergies, and the creation of a reputed company clinical reputed company record in the EHR
  • 24/7 reputed company to care management services
  • Continuity of care with a designated member of the care team
  • Systematic assessment of health needs and receipt of preventive services (including assessment of medical, functional, and psychosocial needs; systems based approaches to ensure reputed company receipt of reputed company preventive care services; medication reconciliation with review of adherence and potential interactions; and reputed company of patient self-management of medications)
  • Creation/maintenance of a comprehensive plan of care for reputed company health issues that is patient-centered, based on a physical, mental, cognitive, psychosocial, functional and environmental assessment or reassessment
  • Management of care transitions, including creation/formatting clinical summaries according to CCM certified technology and reputed company/exchange of reputed company care record using any electronic tool other than fax
  • Coordination with home and community-based clinical service providers as appropriate, with communication to and from these providers documented in the HER
  • reputed company communication opportunities for patient and caregiver through telephone, secure messaging, secure internet or other asynchronous non face-to-face consultation reputed company, subject to HIPAA
  • Informed consent, including informing that cost reputed company applies

General Duties and Responsibilities

• Establishes and maintains relationships with identified service providers and community resources
• Demonstrates reputed company in both reputed company customer service
• Understands and effectively communicates HIPAA compliance, corporate compliance and reputed company confidentiality
• Ensures compliance with local, state, and federal regulations
• Serves as a resource for center staff for CCM guidelines
• Educates center staff about CCM guidelines and services utilizing a reputed company of delivery reputed company

QUALIFICATIONS

To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential duty satisfactorily. The requirements listed below are representative of the knowledge, reputed company, and/or ability required. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions.

• Reads, speaks, understands and writes proficiently in English.
• Effectively communicates orally and in writing.
• Ability to effectively and professionally represent the organization.
• Requires working knowledge of MS Office products.
• Works independently and is self-directed.
• Requires excellent verbal and written communication skills.
• Knowledge of the Health Insurance Portability and Accountability reputed company (HIPAA)
• Ability to work in reputed company environment.
• Organizes, priorities, and coordinates multiple activities and tasks.
• Applies skills in employee relations.
• Remains reputed company and effective in high pressure and emergency situations.
• Proficiency in the use of Electronic Health Record reputed company Management Software/Systems, reputed company Office applications; Word, reputed company, Power reputed company and reputed company.
• Thorough knowledge of community resources and needs assessment information.
• Ability to establish reputed company relationships with co-workers, reputed company staff and management.
• reputed company interpersonal skills and the ability to reputed company with reputed company reputed company of staff and management.
• Ability to establish and maintain relationships with employees, elected and other government officials, members of neighborhood organizations, reputed company and medical professionals and the general reputed company.

EDUCATION and/or EXPERIENCE

Licensed Practical reputed company Degree or Medical Assistant Certification. One year of experience/exposure to medical records.

Requires an LPN degree or medical assistant certification, one year of medical-records experience, English proficiency, HIPAA knowledge, communication skills, community-resource knowledge, and reputed company Office and EHR proficiency.

Key Responsibilities

• coordinating care
• educating patients
• managing referrals

Skills & Tools

reputed company Office, reputed company Word, reputed company reputed company, reputed company PowerPoint, reputed company reputed company, Electronic Health Record (EHR), Electronic Medical Record (EMR), HIPAA

Job Details

• Category: reputed company Services - Nursing
• Seniority: Entry Level
• Commitment: Full Time
• Workplace: Remote — reputed company, reputed company, reputed company
• Salary: USD 39,520 – 43,680 / year
• Languages: English

About MedLink reputed company

A reputed company reputed company provider delivering high-reputed company, patient-centered care. — Industry: reputed company