COMPLETE HEALTH GROUP Salary - Salary Report

A general knowledge of primary care clinics, disease management and medical terminology is essential
competency in prevention strategies and care planning for patients with comorbidities
experience in care coordination, health education, patient engagement and social services is required
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knowledge of hospitals, specialists, and ancillary health services throughout the assigned community is preferred
provides CCM services primarily to a panel of low acuity Traditional Medicare and Medicare Advantage plan patients who are assigned to his/her care by the Nurse Care Manager of Clinical Services and/or the RN Care Manager
works in collaboration with the Nurse Care Manager of Clinical Services and patient's PCP to create and modify patient care plans and associated patient goals and instructions
participates in department rotating "on-call" schedule determined by the Nurse Manager of Clinical Services
documents the appropriate criteria for Chronic Care Management , Transitional Care Management , and behavioral health integration for eligible patients and relays that information to the appropriate Care Management team member
completes telephonic campaigns for annual wellness visits, health risk assessments, and other quality improvement measures as assigned and directed
attends meetings for updates; as directed

complete Health group
birmingham
go to click.appcast.io
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he/she provides information for basic social services, application assistance, and care planning to patients, as needed
he/she is responsible for ensuring billing and documentation is complete for chronic care management eligible patients
under direction of the Nurse Manager of Clinical Services the Care Coordinator provides and facilitates communication of health information and performs clerical and clinical documentation and other support services for low acuity patients in the Chronic Care Management program
he/She is responsible for triaging, coordination, documentation, communication, and tracking of low acuity CCM patient's calls, cases and records and assists in the development of care plans, conducts appointment scheduling, referral processing and medication management
the Care Coordinator engages patients and their families and/or representatives for disease management and education sessions to promote positive health and behavioral modifications
under the direction of the Nurse Manager of Clinical Services, he/she provides transition of care services to patients being discharged from post-acute settings; such as hospitals and skilled nursing facilities

functions independently to perform age-appropriate history and physical for complex acute, critical, and chronically ill perioperative patients
orders and interprets diagnostic and therapeutic tests relative to patient's age-specific needs
prescribes appropriate pharmacologic and non-pharmacologic treatment modalities
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assists with the provision of surgical care in accordance with facility, state, and federal regulations
monitors the effectiveness of interventions
facilitates the patient's transition within and between health care settings, e.g. admitting, transferring, and discharging patients
collaborates with multidisciplinary team members by making appropriate referrals
implements interventions to support the patient to regain or maintain physiologic stability, including but not limited to serving in the first assisting role

COMPLETE HEALTH GROUP