We are a value-driven healthcare company committed to providing personalized care to aging and underserved populations. We align stakeholders across the healthcare ecosystem to improve consumer experience, optimize clinical outcomes, and reduce total cost of care. Our values are: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
The Care Manager coordinates and facilitates members’ individualized plans of care in collaboration with members, families, caregivers, and other healthcare providers. The Care Manager uses their clinical judgment to determine a member’s needs both in the home and throughout an acute care episode. This role also supports a variety of care programs, outreach, education, quality improvement, and other initiatives as needed. This position is 100% remote but candidates must reside in CA. Some travel is required within CA.
Responsibilities:
- Conducts face-to-face (virtual and in person) visits with members in both healthcare facilities and in their homes and initiates telephone outreach
- Facilitate “Intakes” and maintain required documentation in EMR web-based application including but not limited to the following: Surveys, Health Risk Assessments, progress notes, and other documentation as required by Bright Health.
- Uses all components of the Transition of Care model and nursing process including assessment, triage, planning, implementing, and evaluating care to meet the members’ needs
- Provides health maintenance, medication, and disease management education to members and families/caregivers
- Coordinates appropriate member care appointments, community resources, referrals, management program benefits, and special focus programs
- Ensure members’ preventive care appointments are scheduled and encourage the member to participate in those appointments.
- Maintains compliance with CMS-mandated health risk assessments, care plans, and interdisciplinary care team requirements.
- Active participation in Interdisciplinary Care Team presentations, if indicated.
- Coordinates continuity of care, prevention, and avoidance of complications, and close clinical treatment and management under the direction of the members’ primary healthcare provider(s) and medical directors
- Takes an active role in coordinating and initiating member’s access to Bright Health programs and specialty benefits offered beyond traditional Medicare
- Effectively communicates, problem-solves, and maintains productive and effective interpersonal relationships while effectively prioritizing patient care.
- Works with outside facilities, agencies, and vendors on a routine basis, maintaining positive working relationships
- Supports members and their families/caregivers, and provides compassionate care
- Frequent travel is required for member visits, conferences, community events, health fairs, etc.
- Make referrals/linkages to community resources on an individualized basis.
