Care taker job description

Sunrise Senior Living was again named as one of the Best Workplaces in Aging Services™ by Fortune and certified as a Great Place to Work by Activated Insights. This is the 5th time Sunrise has received this top culture and workplace designation, highlighting the special place Sunrise is to be a part of.

2022-176403

Sign on Bonus

JOB OVERVIEW

"It makes me feel good knowing that we make the residents' lives better. We laugh with them, cry with them, sing and dance with them - we brighten their day. Working here is an unbelievable privilege and it will be something I carry with me for the rest of my life!"- Sunrise Team Member

At Sunrise, our Care Manager is responsible for providing the highest degree of quality care and services to a consistent group of residents and their families in our assisted living and reminiscence neighborhoods.

RESPONSIBILITIES & QUALIFICATIONS

Responsibilities:

* Build meaningful relationships with a specified number of seniors and their families as you provide assistance with activities of daily living, attend to individual care needs and get to know their unique preferences and personalities - Notify management of changes in condition and recommend adjustments in the level of care and service - Assist residents in life skills and other life enriching activities as indicated on their individual profile - Blends a variety of multi-sensory experiences into the resident's day
* Participates in the development of the Individualized Service Plans (ISP) and monthly updates
* Responsible for their designated group of residents during the shift, knows where their residents are and physically checks on them throughout the shift.
* Partners with community team to ensure community is in compliance with OSHA requirements and promotion of Risk Management programs and policies; adherence to safety rules and regulations.
* Responds to the dining needs of the residents and guests while maintaining Sunrise hospitality and service standards
* Invite, Encourage, Assist (IEA) residents in life skills and other life enriching activities as indicated on ISP and demographic profile
* Committed to serving our residents and guests through our Principles of Services

Qualifications:- Dedication to and passion to serve seniors with excellent customer service skills - Positive attitude, the flexibility to perform various duties in service to the residents and the ability to work in a team environment are keys to success- High School diploma/GED accepted and may be required per state regulations- In states where appropriate, must maintain certifications- Must be at least 18 years of age- Previous experience working with seniors preferred- Ability to make choices, decisions and act in the resident's best interest- Possess written and verbal skills for effective communication and a level of understanding- Competent in organizational and time management skills- Demonstrate good judgment, problem solving and decision making skills

Sunrise considers the health and safety of its residents, family members, and team members as its highest priorities. All offers of employment with Sunrise are conditioned on completing and passing a background and drug test, participating in mandatory vaccine programs (e.g., Covid-19), participating in testing requirements (e.g. Covid-19, TB) and using designated PPE when required.

Sunrise Senior Living offers a comprehensive benefits plan to eligible team members including health, dental, vision, retirement benefits, short-term disability, long-term disability, and paid time off. Team members may also be eligible to receive a bonus based on their position. Some leadership roles are eligible to receive annual bonuses. All team members have the potential to receive spot bonuses and other incentive awards.

ABOUT SUNRISE

Sunrise Senior Living has championed quality of life in senior care for more than 30 years. We believe team members are our greatest resource and are looking for people who share our commitment to provide quality care for seniors and their families. It's no surprise that many of the world's leading experts in Senior Living entrust their career to Sunrise.

At Sunrise, you will…Make a Difference Every DayWe are passionate about our mission - to champion quality of life for all seniors. We deliver high-quality care with a personal touch and encourage our residents to enjoy life to the fullest.

Be Part of a Uniquely Supportive CommunityThe care-focused environment we create for residents extends to our team members. We offer programs, rewards, and benefits to help you live your best.

Ignite Your PotentialWe believe potential has no limits. We offer best-in-class leadership development programs designed to grow our leaders. We are committed to helping our team members achieve their career goals.

Sunrise Senior Living was again named as one of the Best Workplaces in Aging Services™ by Fortune and certified as a Great Place to Work by Activated Insights. This is the 5th time Sunrise has received this top culture and workplace designation, highlighting the special place Sunrise is to be a part of.

Apply today to learn why Sunrise Senior Living is a certified Great Place to Work

Inpatient Care Coordinator

UnityPoint Health - Fort Dodge

FTE: 1.0 (Full-time, 40 hours per week)

Shift: Monday-Friday *No weekends - no holidays*

Why UnityPoint Health?

* Culture - At UnityPoint Health, you Come for a fulfilling career and experience a culture guided by uncompromising values and unwavering belief in doing what's right for the people we serve.
* Benefits - Our competitive Total Rewards program offers benefits options like 401K match, paid time off and education assistance that align with your needs and priorities, no matter what life stage you're in.
* Diversity, Equity and Inclusion Commitment - We're committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation.
* Development - We believe equipping you with support and development opportunities is an essential part of delivering a remarkable employment experience.
* Community Involvement - Be an essential part of our core purpose-to improve the health of the people and communities we serve.

Visit us at UnityPoint.org/careers to hear more from our team members about why UnityPoint Health is a great place to work. https://dayinthelife.unitypoint

Responsibilities

* Screens 100% of adult Medical Surgical in-patient and observation patients and assesses the individual's health status including clinical conditions, support systems and resources to identify needs and make referrals to appropriate multi-disciplinary services.
* Prioritizes patients for care coordination based on defined criteria.
* Monitors and coordinates an interdisciplinary plan of care in partnership with the individual and their support services for needs and services across the health care continuum and for transition through the levels and locations of care.
* Assumes accountability for the development and implementation of an effective discharge plan for complex care patients. Works with internal and external resources to co-ordinate a timely safe transition of patient to the appropriate level of care.
* Lead and participates with the interdisciplinary team in daily rounds, planning delivery and evaluation of patient-focused care for prioritized patients.
* Tighter integration with ambulatory care management team, especially with high risk, chronically ill patients.
* Utilize standard alert to inform cross continuum care managers when patients are admitted.
* Works closely with providers for discharge planning and determining the next level of care.
* Collaborates with patients, caregivers, internal/external healthcare providers, agencies and payers to plan and execute a safe discharge.
* Collaborate with Utilization Management team on continued stay review
* Collaborates with patients, caregivers, internal/external healthcare providers, agencies and payers to plan and execute a safe discharge.
* Optimize utilization of Healthwise for Patient Education.
* Demonstrates a working knowledge of financial and reimbursement processes to facilitate medical cost management, including best practices, effective utilization of resources, linking clinical and financial aspects of care, and access to care and level of care.

Qualifications

Education:

Bachelor of Arts/Science degree in health care or social work related field

Experience:

Two years of clinical experience in focused areas working with multidisciplinary teams.

License(s)/Certification(s):

Current RN or Discipline-Specific Licensure in state of residence.

Knowledge/Skills/Abilities:

Writes, reads, comprehends and speaks fluent English.

Basic computer knowledge using word processing, spreadsheet, email and web browser.

* Area of Interest: Nursing;
* FTE/Hours per pay period: 1.0;
* Department: Care Coordination;
* Shift: Monday-Friday, 8 hour shifts;

Facility:Corporate Offices

CitySan Diego

Department

Job Status

Regular

Shift

Day

FTE

1

Shift Start Time

Shift End Time

Other; Other; Other

Hours

Shift Start Time:

8 AM

Shift End Time:

5 PM

Additional Shift Information:

Weekend Requirements:

No Weekends

On-Call Required:

No

What You Will Do

The UM Care Coordinator, under the direct supervision of the Supervisor, Utilization Management Care Coordinators, prepares referral requests for outpatient services, elective inpatient admissions, skilled nursing facility admissions, durable medical equipment (DME), and home health, utilizing health plan web sites to obtain benefit verification information and medical necessity criteria, to be utilized by the licensed staff to determine the medical appropriateness of the requested service. This position is responsible for conducting retrospective claims review for services to determine the medical appropriateness of the provided service. Support SCMG provider practices in facilitating referrals for services for members in a timely manner in observance of regulatory requirements.

Required Qualifications

+ Other Successful completion of Medical Assistant Program or equivalent.

Preferred Qualifications

+ Other Successful completion of Medical Terminology course.

+ Other Successful completion of ICD-9 and CPT coding classes, or equivalent work experience.

+ 3 Years Experience working in the managed health care field, preferably HMO or delegated risk medical group/IPA setting.

+ 1 Year Experience with medical coding and data entry, preferably in a managed care environment.

Other Qualification Requirements

+ Microsoft Word and Excel certification preferred.

Essential Functions

+ Prior Authorization

Obtain necessary medical/clinical information utilizing multiple sources including use of specific medical group electronic health records by following SCMG documented operational processes.

Accurately interpret external criteria and internal operational documents.

Ensure medical necessity criteria selected is appropriate for the referral request being reviewed.

Document in the referral management system, according to SCMG operational processes, actions taken on each referral processed including, but not limited to telephone calls made to obtain needed information, documentation of actions taken related to the processing of the referral.

Attach corresponding documents to the referral within the referral management system in OnBase, the document management system.

Refer referral requests for review by licensed staff and Medical Directors within required turn-around times (TAT).

Triage ACES Contact Us emails, Customer Service emails and CSRs, and Network Management referral requests.

Serve as a liaison to the Care Management team and assist with obtaining requested information.

+ Benefit Verification

Ability to proficiently navigate health plan web sites.

Verify member eligibility status.

Obtain detailed benefit coverage for service requests in accordance with the member's benefit plan coverage.

Accurately interpret health plan benefits.

Apply the benefit guidelines to approve referral requests as outlined in the SCMG prior authorization document and desktop procedures.

Research and assist in the benefit denial process by utilizing SCMG operational documents to obtain necessary documentation, such as member specific health plan Evidence of Coverage (EOC), health plan coverage criteria, etc.

+ Retrospective Review

Coordinate, review, and process retrospective claims for medical care and services including, but not limited to emergency room visits, urgent care visits, outpatient care, medical transportation, durable medical equipment.

Ensure the retrospective claims review process is completed within the required regulatory turn-around times (TAT).

Provide a determination for services that designated on the PAR document as well as the SCMG operation documents as appropriate for approval at the UM Care Coordinator level of review.

Appropriately identify claims for review by the Medical Director to include obtaining the appropriate medically necessary criteria or benefit documents.

Accurately complete the eMD for and forward the claim with all applicable information to the Medical Director.

+ Quality and Productivity Performance

Achieve 90% or greater quarterly audit results.

Complete tasks accurately with minimal supervision.

Complete work and assigned tasks within specified timeframes.

Maintain the established performance metric of designated average volume of referrals per day.

+ Professional Development

Keep current knowledge and understanding of applicable accreditation and regulatory statutes related to health care, managed care, as it related to the position.

Bring to attention of the Supervisor, Utilization Management Care Coordinators, and UM Manager, areas of UM non-compliance and provide input on actions for improvement.

Serve as a resource and mentor to Health Services teams and other department staff.

Establish mutually derived annual goals and meet goals.

Maintain individual in-service/performance records.

Attend and actively participates in department/team process/quality improvement activities.

Knowledge, Skills, and Abilities

+ Excellent working knowledge of medical terminology, CPT, ICD, HCPCS codes and its appropriate utilization use and application in referral management.

+ Knowledge of health insurance or HMO benefits.

+ Strong understanding of referral management processes.

+ Ability to present information succinctly and accurately.

+ Ability to be highly flexible, and think independently.

+ Requires excellent communication skills with the ability to communicate clearly and professionally, both verbally and in writing.

+ Ability to work independently, plan, organize, manage changes, follow directions accurately, and use resources in an organized manner.

+ Strong organizational skills with attention to detail and ability to handle and prioritize multiple conflicting priorities. Successful completion of a medical terminology course.

+ Proficiency and understanding of the following referral management applications: ACES/Optum Portal, IDX, OnBase workflows, Right Fax, and other internal tools such as eMD, for consistency, integrity and accuracy.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class