Responsibilities
- Collaborate to evaluate, design, and manage ongoing care for patients with complex health or behavioral conditions to support quality and cost-efficient outcomes.
- Conduct on-site and remote evaluations of hospital admissions to verify medical necessity and appropriate care levels.
- Create, monitor, and modify individualized care plans to achieve optimal patient outcomes.
- Coordinate care among primary care providers, specialists, and other medical or social service professionals to address full-spectrum patient needs.
- Conduct in-person visits with high-risk patients at service locations when required.
- For BCHP members only, perform in-person assessments at the point of care.
- Educate patients and healthcare providers on care plans, treatment options, and resources.
- Recognize and escalate potential quality or risk management issues to appropriate personnel.
- Enter patient assessments and care authorizations accurately into the designated system.
Work Arrangement
Hybrid
