Care Manager

Skills:
·       Registered Nurse in the state of DE
·       5 years of Intensive Case Management and Discharge Planning experience
·       Experience completing Assessments, developing Service Plans and Care Plans
Responsibilities:
·       Assess, plan, coordinate, implement and evaluate care for eligible members with chronic and complex health care, social service and custodial needs in a nursing facility or home and community-based care setting.
·       Facilitate authorization, coordination, continuity and appropriateness of care and services in community or HCBS.
·       Facilitate transitions to alternate care settings such as hospital to home, nursing facility to community setting using an integrated care team to address the member’s specific needs.
·       Provide education, resources, and assistance to help members achieve goals as outlined in their plan of care and to overcome obstacles to achieving optimal care in the least restrictive environment.
·       Develop a plan of care in conjunction with members or caregivers to identify services to meet the member’s specific needs, and goals.