Job Title: Care Manager
Job Description
The Care Manager is responsible for providing care management services to beneficiaries with planned admissions to acute care hospitals or those transitioning from case management or disease management programs. The role systematically identifies and addresses fragmented care for patients with acute, real-time needs and tailors interventions and services to fill gaps and produce optimal clinical outcomes cost-effectively.
Responsibilities
- Pre-Admission Counseling: Contact patients with upcoming hospital admissions to discuss expectations and assess their condition to understand illness or injury. Advise patients of probable length of stay and help arrange for services at discharge.
- Admission Care: Work with physicians and hospitals to enforce treatment plans and orders. Ensure patients receive specialty care and tests as ordered. Coordinate health care team services to avoid duplication and conserve benefit dollars. Authorize equipment, supplies, and services as needed.
- Coordination of Care: Conduct hospital visits, confer with physicians to clarify diagnosis and treatment plans, and authorize recommended modalities of treatment. Document case summaries in Transitional Care Plans and facilitate beneficiary transfers among regions.
- Coordination of Financial Services: Assess patients' benefit plan coverage and limitations. Negotiate cost-effective rates for provider services and suggest medically appropriate, cost-effective alternatives to achieve treatment plan goals.
- Post Discharge Follow-up: Contact patients within 48 hours of discharge to ensure sufficient support for full recovery. Ensure proper receipt of equipment and services, assess compliance with medications and follow-up appointments, and assist patients in navigating the health care system effectively.
Essential Skills
- Graduate of Nursing program or Graduate in Clinical Psychology or Clinical Social Work
- 2 years of experience
- Current, valid and unrestricted Registered Nurse license
- Proficiency in computer skills and Microsoft Office Suite (Excel, Outlook, Word)
- Experience in case management and managed care
- Strong customer service skills
- Bilingual in Spanish (preferred)
Additional Skills & Qualifications
- Experience in home health, hospice, or hospital settings
- Telehealth and telephonic care experience
Work Environment
Remote work environment. Must have strong WiFi and a room to work in with a closed door. The work schedule is Monday to Friday, 11:30 AM to 8:00 PM EST initially, with the potential to transition to four 10-hour days after proving competency on contract. The role is not patient-facing.
Pay and Benefits
The pay range for this position is $35.00 - $41.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
- Medical, dental & vision
- Critical Illness, Accident, and Hospital
- 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
- Life Insurance (Voluntary Life & AD&D for the employee and dependents)
- Short and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Apr 11, 2025.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & Inclusion
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
- Hiring diverse talent
- Maintaining an inclusive environment through persistent self-reflection
- Building a culture of care, engagement, and recognition with clear outcomes
- Ensuring growth opportunities for our people
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
