Any Case Managers who work with Medicaid patients?

Specialties Case Management

Published

I have a question to case managers out there. I am thinking about taking a job being a case manager for Medicaid patients on the REM program in Maryland (REM= rare and expensive medical issues). It is a work from home job and I would be required to do meet with the patient sometimes (the highest acuity patients are seen once every 3 months). I was wondering if any case managers who do something similar could tell me what a typical case load is (they said mine would be 60). I don't know if this is way too much or not. Also, I live in an urban area and wondering how case managers deal with having to visit patients that might live in a bad neighborhood. How do you keep safe? I know that they suggested seeing the patients at their doctors appointment and talk to them while they are waiting but what if that isn't possible.

I really am excited to work with this population and to work from home. I just want to make sure that I know what the pros and cons are before seriously considering this position. Plus I'd like some advice on how to do a good job. So any tips and hints are welcome, including how you organize yourself and manage your time. Is there a method you use that you could share? Maybe a good excel spreadsheet format or anything similar?

Thanks!

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Specializes in Assessment coordinator.

The math works out to 4 visits a week, right (60 patients over 3 months=20 visits a month.)? So, even though you are working from home, you are going to be in clothes, not jammies and fuzzy slippers at least 2-3 days a week, assuming you can do more than one visit in a day. The paperwork for recording your visits will be a couple of hours. You will be on conference calls, and reporting to the medical director once a week or more, as well. You will be on the phone a lot. You will be on hold a lot. Your office space at home will be inspected at least once a year announced, and possibly once a year unannounced. Things to ponder. Your calls will be monitored and recorded, and listened to by your supervisor. But, actually, it's probably a great job. You can visit your dialysis patients at dialysis, as well.

ST

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Specializes in LTC, Case Management.

I work for a Medicaid waiver program where we go out and visit clients in their homes. We arrange services for them to prevent them from entering a nursing facility. I was TOLD that my case load would be about 60, and per the state guidelines, that is were it is suppose to be. However, I have 80 clients right now. We have to visit them in their homes, not MD offices, etc because it is their homes that we have to make sure have the HME's they need to be safe and fuction to their capacity. Also to evalute their support systems and needs based on where THEY live.

We all use outlook to organize our follow up calls and Excel to organize our caseload visits. I have to see every consumer once every 3 months unless they are on 24 hour supervision or require more frequent monitoring (frequent hospitalizations, disconnected family situations, etc). Those clients we see monthly. I have approximately 35 visits per month and about 5-6 reassessments (done annualy for each client) a month. It is tough to get all of the work in, along with case managing every client monthly, but the job is extremely flexible on time and working from home never ends at 4 pm....there are days I work until 11 pm getting documentation done.

Working in the field can be challenging at times. My husband was furious when I started and tried to convince me not to take this job because of the location of the field work I would be doing. I work in some of the worst parts of a major metropolitain area. Every other house on some of the streets I visit is borded up. Gangs flock at the corners and MANY of my clients and/or their families have criminal records. However, I have to admit, there have only been a handful of cases that I did not feel comfortable walking into a home. Generally, the people know you are there to help them and provide them with services and they watch out for you. We have the option of taking security with us. I have never used them and most of my co-workers don't either. We have never had any problems.....and the few times I did feel uncomfortable, I left and finished the visit on the phone the next day. You will learn which homes to go early in the morning before the drug deals happen on the corner and which ones to avoid after school lets out. Honestly, it is not the crime that I worry as much about as bringing roaches and bed bugs back home with me!

But I have to admit.....I love my job. There are definitaly challanges to it, but the flexibility of working at home and making my own schedule is all well worth it. And for the record, I have NEVER had anyone come out and check my office at home or check up on me in the field. Just make sure your work is done and you won't have any problems. Working at home does not mean working in your pajamas (well, some days it does) or working less. You will find you usually are working more, but you are at home!!!

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Dang I just read that and thought you must work with me lol! But Im in TN.....I work for same type program. I have 80-sumthin members right now. Some of my coworkers have over 100. We have a mix of home based and also nursing home members. You are very right in the working all hours. It takes AT LEAST 30 minutes or more to do the paperwork after a home visit, sometimes almost an hour. We have soooooo much stuff to fill out when we go into homes, the visits always end up being 1 1/2 to 2 hours. New member visits take up to 4 hours! It is tiring and hard to get many visits in in one day.

I have not had to go into any bad areas so far.

Ive only been able to work in pj's one day this week lol...I have visits the other four.

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Your office space at home will be inspected at least once a year announced, and possibly once a year unannounced. Things to ponder. Your calls will be monitored and recorded, and listened to by your supervisor. ST

Not all companies inspect your home office to ensure you have a 'locked file cabinet' nor are your calls monitored and recorded. I work from home and my home office is NOT inspected nor all my calls monitored or recorded. I have a friend that works for Healthways and her home office was inspected after she was hired. Hope this helps.

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At one place I worked for we did paper charting so we actually kept member charts in our home office, so we did have to have our manager inspect it to make sure they were locked in file cabinets. Now where I work it's all computer charting....so basically my office is anywhere! I can work from home, my car, friend's house, vacation, anywhere. It's ALL on the laptop so there is no office to inspect. Very convenient!

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At one place I worked for we did paper charting so we actually kept member charts in our home office, so we did have to have our manager inspect it to make sure they were locked in file cabinets. Now where I work it's all computer charting....so basically my office is anywhere! I can work from home, my car, friend's house, vacation, anywhere. It's ALL on the laptop so there is no office to inspect. Very convenient!

Yes, paperless is wonderful. So in that previous job how often did your manager come to your home to inspect your file cabinet? My friend that works for Healthways said her manager made an unannounced visit to check her file cabinet when she was initially hired.

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I only had my home office checked once. And it was scheduled not unannounced. My manager just sat and watched me work a lil bit then left.

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What is the name of the company you work for? I am very interested!

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