Job Description
Provides telephonic clinical care management services using evidence-based practices to ensure patients receive appropriate, high-quality care that allows them to remain safely in their homes or communities.
Key Responsibilities
- Coordinate and oversee the delivery of benefits and services for assigned members.
- Complete comprehensive care management and disease-specific assessments.
- Make timely telephonic care management calls based on patient risk level.
- Resolve and coordinate complex member issues impacting care delivery.
- Provide health education and coaching to members and caregivers.
- Assess social determinants of health (SDoH) and coordinate care to address barriers.
- Identify member safety issues and connect to appropriate resources (therapy, DME, behavioral health, etc.).
- Ensure high-quality, cost-effective care aligned with evidence-based clinical guidelines.
- Advocate for members and caregivers to obtain needed health services.
- Promote adherence to physician treatment plans through education and support.
- Reduce inappropriate ER and hospital utilization by increasing access to preventive and primary care.
- Participate in interdisciplinary team (IDT) meetings and case discussions.
- Maintain confidentiality of all member information and ensure compliance with federal, state, and payor regulations.
- Must have working knowledge of Medicare and Medicaid programs.
Numbers & Facts
| Location | NY, NY |
| Industry | Staffing/Employment Agencies |
| Salary | $61 |
| Company Size | 50 to 99 employees |
| Year Founded | 2002 |
| Website | https://phaxis.com/ |
About Company
We stand for PERSEVERANCE, as we refuse to quit when the journey gets tough. Your gold is our mission, and we search day and night to find it.
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