Lead Care Manager at CNSCares

Oak Ridge, Tennessee, United States -

Full Time

Start Date

Immediate

Expiry Date

23 Jun, 26

Salary

45000.0

Posted On

25 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Utilization Management, Payroll Tasks, Training, Mentoring, Professionalism, Customer Service, EEOICPA Program Guidance, On-Call Scheduling, State Regulations Familiarity, Accreditation Regulations Familiarity, Business Intelligence Tool Usage, Clinical Compliance Monitoring, Communication, Electronic Medical Record (EMR) Scheduling, Staffing Coordination, Durable Medical Equipment Coordination

Industry

Hospitals and Health Care

Description

Description Salary: $45,000 per year or more depending on experience, plus bonus potential Location: Oak Ridge, TN In-Office, Full-Time, Monday-Friday (Participates in on-call rotation to assist with scheduling) Benefits Summary Medical, dental, vision, and 401K Health Savings Account (HSA) Matching 401k Unlimited Paid Time Off (PTO) Mileage Reimbursement Position Summary On behalf of CNS Cares (“CNS” or “Company), the Lead Care Manager is responsible for all duties of a Care Manager, additionally the Lead Care Manager will take on additional responsibilities learning state and accreditation regulations, overseeing and managing utilization, payroll tasks and training/mentoring new care managers. Essential Functions Employee must have regular attendance/punctuality, be able to work with others at all levels of the Company, have exceptional customer service, and be completely honest. Other assigned duties include: Always maintains and exhibits professionalism. Become a specialist in the DOL program and how it applies to sites/former workers in their assigned state/region. Provide guidance to leads and patients on all aspects of the EEOICPA program. Works with General Manager to develop, implement and communicate an on-call schedule. Monitor and oversee utilization. Work with other care managers to maximize utilization when able. Become familiar with state regulations and accreditation regulations (where applicable). Serves as the back-up administrator in states where applicable. Assume additional payroll tasks Uses the Business Intelligence tool to monitor and outstanding notes and schedule reports and work to ensure reports are clean. Ensure Clinical Compliance tasks are scheduled correctly and monitored for their patient assignment and work with other care managers to mentor and ensure clinical compliance tasks are scheduled appropriately. Demonstrates excellent communication skills. Communicates regularly with patients, nurses, home health aides, and claims team. Communicates with the General Manager and Director of Nursing on patient status and care being provided in home. Schedules visits for the care team within the electronic medical record (EMR). Works to find coverage in situations where there is staffing needs. Works with the recruiting team and local leadership to adequately source and hire new staff. Expectation to utilize 100% of authorized hours. Ensures clinical compliance items are scheduled and completed per company and state guidelines. Identify patient needs for durable medical equipment and coordinate with DME companies to ensure patients’ needs are met. Evaluate patient conditions not currently covered by the Department of Labor and coordinate and assist patients to get consequential illnesses added to their DOL covered conditions. Assist auth team with start of cares and renewal periods to advocate and justify the appropriate care level for each patient. Attend medical appointments with patient to assist as a resource to physicians regarding the Department of Labor Home Health Care program. Gather medical records as needed. Ensure all authorized units are staffed by the assigned skilled nurse or home health aide with expectation to limit overtime. Coordinate with GM and DON for appropriate direction. Provide EMR and home orientation training to staff. Participate in an on-call rotation. Adhere to all company policies. Knowledge of HIPAA regulations and the ability to maintain strict confidentiality of patient information. Ability to establish interpersonal relationships with people from diverse socioeconomic and cultural backgrounds. Able to wear personal protective equipment (e.g., face mask, goggles, latex/non-latex gloves) as needed. Ability to work effectively within role independently and with other team members. Ability to organize and complete work in a timely manner. Ability to understand medical/surgical terminology. Ability to travel up to 80% of time in designated territory. Other duties as assigned Requirements Experience / Education Required: Must be at least 21 years of age. At least two (2) years of Staff Scheduling or Case Management experience CPR Certification At least three (3) years of healthcare experience Preferred: Home health experience strongly preferred Department of Labor / EEOICPA experience strongly preferred Associates or Bachelors degree preferred Clearances The following background checks are conducted: Criminal background Driving Record OIG Exclusion List Sex Offender Registry #TFIND

Responsibilities

The Lead Care Manager performs all duties of a Care Manager while taking on additional responsibilities such as learning state and accreditation regulations, overseeing utilization, managing payroll tasks, and training/mentoring new staff. Key functions include providing guidance on the EEOICPA program, developing on-call schedules, monitoring clinical compliance, and coordinating patient care logistics.