The Clover Care Services organization delivers proactive support and care to our members through our clinical Clover Home Care teams, and quality improvement services to our aligned providers through our practice engagement team. The Program Manager, Clover Care Services (CCS), will support the Dialysis Care Management (DCM) Program, ensuring comprehensive care for Clover Health members with ESRD receiving dialysis.
Requirements
- Lead outreach to newly identified and existing targeted Clover Medicare Advantage (MA) plan members
- Introduce and enroll into the DCM program, explain benefits and conduct needs assessments
- Collaborate with members to address any barriers to completing appointments including transportation, scheduling and overall provider satisfaction
- Provide education to members on dialysis adherence
- Build relationships with dialysis providers to track completed and missed appointments
- Follow-up with members for missed appointments to understand reasons and offer assistance as needed including transportation services and scheduling assistance
- Identify chronically non-adherent members and engage to uncover barriers
- Schedule follow-up appointments with CCS providers as needed
- Refer members to Supportive Care or Behavioral Health for clinical decline or reconsideration of hemodialysis continuation
- Document assessments in the electronic medical record and maintain accurate records in the program tracker
- Work collaboratively with internal and external resources including providers and behavioral health specialists, pharmacists, nephrologists, and dialysis center care managers
- Monitor reports and dashboards to identify trends, discover opportunities and implement program improvements
Benefits
- Financial Well-Being
- Physical Well-Being
- Mental Well-Being
- Professional Development
