What are the responsibilities and job description for the Medical Mutual Care Manager - Per Diem position at Council on Aging of Southwestern Ohio?
Medical Mutual Care Manager – Per Diem
15 to 20 hours per week
Council on Aging of Southwestern Ohio (COA) is a nonprofit organization dedicated to enhancing quality of life for older adults, people with disabilities, their families and caregivers. We promote choice, independence, dignity and well-being through a range of services that help people remain in their homes for as long as possible.
COA is a state-designated Area Agency on Aging, serving a 5-county region. One call to COA links people to the wide variety of agencies, information and programs that serve older adults and people with disabilities.
COA has more than 400 employees, close to 300 contracted providers, and an annual budget of over $128.4 million.
Our mission: Enhance lives by assisting people to remain independent through a range of quality services.
Position Description: Provide Care Transitions Interventions to eligible clients identified by Medical Mutual in Hamilton County. Utilize Coleman Mode as the intervention. Provide health coaching via a beside visit, post-discharge home visit and follow up phone calls.
Essential Job Functions:
- Meet with clients in their home post discharge.
- Conducts telephonic visits with client as appropriate to engage in the program.
- Focus on the 4 pillars of Care- Medication reconciliation, follow up with PCP, personal health record and identification of red flag issues/concerns
- Collaboration with PCP
- Connection to community resources and support through ADRC or through Medical Mutual plan for unmet social determinates of health
- Complete 1500 Medicare Claim Form for all Medicare Advantage Plan members receiving medication reconciliation
- Case Summary and Physician summary is submitted
- Ensures health and safety of client and intervenes and make referrals as needed.
- All interactions with the clients are documented per policy/procedure in the database Client Track.
- Adheres to Confidentiality Policy and HIPPA policies with all protected health information.
Qualification Requirements:
- Must be an Ohio Registered Nurse or Licensed Social Worker.
- At least one year of experience in home health care, medical social work, geriatrics, care/case management or an equivalent substitute
- A working knowledge and understanding of issues related to the elderly population.
- Knowledge of community resources
- Excellent interpersonal communication skills, sales and customer service skills
- Ability to problem solve and work independently with good organization skills and the ability to manage multiple tasks
- Ability to adapt to frequent change
- Works well with others
- Ability to collaborate and problem solve in a self-directed team environment
- Strong clinical skills including an understanding of and ability to implement evidence-based care
- Understanding of the health care system and its components including sites of care, delivery models, and the roles of various providers and health care professionals.
- Ability to manage client complexity and multiple clients with diverse needs
- Comfort with working independently in a health care facility environment in an independent role.
- Computer skills including Windows Operating System; MS Word; data entry and ability to learn software applications.
- A valid driver’s license and reliable transportation for travel within Hamilton County and surrounding counties.
Salary : $128
