United States onlyConsistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ commitment to superior customer service, implements current policies and procedures, and conducts on-site or telephonic review of active patient care.
Requirements
- Conducts on-site or telephonic prospective, concurrent, and retrospective review of active patient care
- Coordinates treatment plans and discharge expectations
- Meets with patients, patients’ family and caregivers as needed to discuss care and treatment plan
- Identifies and assists with the follow-up of high-risk patients in acute care settings, skilled nursing facilities, custodial and ambulatory settings
- Consults with physician and other team members to ensure that care plan is successfully implemented
- Coordinates provisions for discharge from facilities including follow-up appointments, home health, social services, transportation, etc., to maintain continuity of care
- Communicates authorization or denial of services to appropriate parties
- Demonstrates a thorough understanding of the cost consequences resulting from care management decisions through utilization of appropriate reports
- Maintains effective communication with health plans, physicians, hospitals, extended care facilities, patients, and families
- Provides accurate information to patients and families regarding health plan benefits, community resources, specialty referrals and other related issues
