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Time Type:
Full time
Department:
Senior Care Options (SCO)
All Locations:
East Boston
Position Summary:
The Geriatric Complex Care Manager is responsible for identifying, referring, and successfully enrolling prospective participants into the Geriatric programs. They work directly with the prospective enrollee in a professional and respectful manner, which reflects the needs and concerns of the individual. Uses communication devices/interpreters appropriately, to ensure that the program benefits are well understood and that issues are resolved, and needs met, resulting in a successful and timely enrollment.
This position requires universal skills and proficiencies which include demonstrating a comprehensive understanding of the Health Center’s mission and core values--compassion, diversity, innovation, respect. In addition, the Geriatric Complex Care Manager demonstrates initiative, critical thinking, problem solving, leadership qualities, and effectively engages with the clinical team.
$10,000 sign-on bonus for new full-time RN's!
The Geriatric Complex Care Manager will work with providers to identify and make referrals to the appropriate geriatric programs based on patient needs and eligibility through panel reviews, chart reviews, data analyses, etc.
Duties & Responsibilities:
Responsible for executing marketing and enrollments strategies and cultivating relationships with primary care departments, community organizations, senior centers, and elderly & disabled housing etc.
Network by presenting at different departmental and managers' staff meetings to promote awareness and education of specialty programs, expand referral sources, and membership growth to the geriatric program.
Perform enrollment-related activities, such as identifying potential prospects, screening leads to ensure eligibility requirements, and explaining the program.
Recommend changes to the referral and enrollment process. Works with the providers to educate referral sources and make recommendations for outreach efforts.
Participate in health fairs and events as appropriate to promote Geriatric Programs
Maintains case load of potential enrollment participants and monitors/manages timely enrollment by working with the PACE enrollment team and the CCA Enrollment Specialist.
Establishes and maintains productive relationships with referral sources. Communicate with referral source via epic on the progression of the enrollment process for referred individuals.
Maintains consistent communication and collaboration with referring departments and providers relating to staff and program issues; ensures that Managers and peers are also informed of these matters.
Determine Eligibility
Check the ongoing status of enrollment opportunities.
Perform panel reviews and chart reviews to vet leads.
Develop and review EPIC reporting to identify prospective participants.
Maintain regular meetings and communication with providers to review panels and specialty referral orders.
Explain geriatric programs and assist participants when needed in the enrollment process.
Measurable Performance Goals
Meet or exceed monthly/quarterly/annual quota as set by VP of senior Care Programs on budgeted new enrollees.
GENERAL REQUIREMENTS: KNOWLEDGE, SKILLS AND ATTITUDES
(This section is not applicable to the initial assessment; all employees and contractors attain these competencies through participation in Geriatric Programs and JACHO orientation programs)
Demonstrates commitment to EBNHC mission by actively promoting the autonomy and dignity of the Geriatric program participants.
Demonstrates commitment to a holistic approach to care by actively engaging in interdisciplinary team planning and communication processes.
Understand the Geriatric Specialties organizational structure. Actively participates in EBNHC programs and committees.
Demonstrates the ability to communicate effectively and respectfully through verbal and written skills. Documents in accordance with protocol.
Displays outstanding customer service skills when interacting with Geriatric participants, family members, outside providers, potential members, referral sources or others.
Interacts with participants in a professional and respectful manner, which reflects the needs and concerns of the individual. Maintains a positive attitude. Uses communication devices appropriately.
Knowledge, Skills, and Abilities Required
EDUCATION:
Graduate of an Accredited Nursing Program.
Licensure in Massachusetts as an RN or LPN.
BLS certification required.
Bilingual skills preferred.
EXPERIENCE:
2–3-year relevant Case Management experience is preferred.
SKILLS/ABILITIES:
Demonstrated ability to communicate effectively both in writing and verbally.
Familiarity with the use of a personal computer in a Windows environment preferred.
