Resurgens Orthopaedics

  • Bundled - Payment Case Manager

    Job Location US-GA-Atlanta
    Job ID
    2018-3050
  • Overview

    Resurgens Orthopaedics is seeking a highly motivated case manager. The case manager will provide case management/care coordination to members enrolled in the Bundled Payment for Care Initiative program, as well as orthopedic commercial insurance bundles.  Resurgens Orthopaedics strives to work collaboratively with our patients, providers and caregivers to ensure a positive outcome, throughout the continuum of care. 

    Responsibilities

    • Responsible for managing a group of Medicare and commercial insurance orthopedic patients throughout a ninety day episode of care.
    •  Gather clinical information from patient records (EMRs) and perform health assessments to determine risk stratification. This includes a comprehensive assessment of physical, emotional,psychosocial, and environmental needs of the patient.
    •  Document clinical assessments and care plans in case management system.
    •  Educate the patient and caregiver of the process and expectations of the health care delivery system throughout the course of care.
    • Development and implementation of care plans throughout the transition of care to ensure the patients well-being.
    • Collaborate with multidisciplinary team members in the acute, post-acute and outpatient settings to identify patient needs such as home health care, DME, physical therapy and community services.
    • Follow up on patients at pre-determined intervals and as needed based on patient status.
    • Complete and submit all required documentation within established guidelines.
    • Evaluate plan of care and revise on ongoing basis as determined by patient's health status and communicate changes to all other disciplines involved in the patient's care.
    • Communicate with providers and multi-disciplinary care team members to facilitate transition of services throughout the continuum of care.
    • Identify gaps or barriers in treatment plans to ensure that discharged patients receive appropriate resources and services.
    • Understand the Bundled Payment Program design, implementation, management, monitoring and reporting requirements.
    • Adhere to the scope of practice for the Registered Professional Nurse per state regulatory guidelines.

    Qualifications

    • RN degree (prefer BSN) with a current Georgia nursing license.
    • Minimum of 2-3 years nursing experience in a hospital setting or case management experience required.
    • CCM (Certified Case Manager credential) or commensurate experience with discharge planning and outpatient care coordination preferred.
    • Experience with the orthopedic specialty preferred.
    • Candidates must possess excellent interpersonal and customer service skills.
    • Role will require strong problem solving skills with a flexible and creative approach to work assignments.
    • Excellent oral and written communication skills required.

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