Unicity Care Management

Sales

• Develop and maintain a robust network of referral partners including physicians, discharge planners, social workers, elder law attorneys, financial advisors, and community organizations.
• Conduct outreach activities such as in-person meetings, presentations, and attending industry events to increase awareness of Unicity’s services.
• Facilitate referrals by understanding client needs, coordinating initial assessments, and connecting families to appropriate care management resources.
• Collaborate closely with internal teams to ensure continuity of care and effective communication throughout the client engagement process.
• Track and document referral activities, partnerships, and outreach efforts in the CRM system to provide accurate reporting.
• Meet outreach and referral generation goals to support business growth objectives.

Clinical Sales Representative

Manager

• Conduct comprehensive in-home assessments covering functional, cognitive, psychosocial, and environmental needs
• Develop and maintain individualized care plans, revising them as circumstances change
• Coordinate physicians, home care, specialists, and community resources into a coherent plan
• Support clients and families through transitions of care
• Provide emotional support and crisis intervention
• Advocate for clients at appointments, care conferences, and points of decision
• Serve as the primary point of contact for clients on the caseload
• Respond to urgent needs outside standard business hours
• Travel regularly for field visits
• Accompany clients to medical appointments and other care-related visits as needed
• Provide high-touch, concierge-level nursing support to clients

Social Work Care Manager, Patient Advocate, LSW/LCSW

• Conduct comprehensive in-home assessments covering clinical, functional, cognitive, psychosocial, and environmental needs
• Develop and maintain individualized care plans, revising them as circumstances change
• Coordinate physicians, home care, specialists, and community resources into a single coherent plan
• Manage transitions of care between hospital, rehabilitation, and home
• Advocate for clients and families at appointments, care conferences, and points of decision
• Serve as the primary point of contact for clients on the caseload
• Respond to urgent needs outside standard business hours
• Travel regularly for field visits
• Accompany clients to medical appointments and other care-related visits as needed
• Provide high-touch, concierge-level nursing support

Nurse Care Manager, Patient Advocate – RN

• Manage a small caseload of private‑pay clients as the primary RN point of contact for clients and families in their homes or in Independent Living, Assisted Living, or Nursing Facilities.
• Perform in‑depth medical, psychosocial, environmental, functional, legal, and family-dynamics assessments.
• Complete and interpret Fall Risk Assessments, Mini-Mental Status Examinations, and Depression Screenings.
• Identify safety issues, changes in condition, and gaps in care; proactively intervene and escalate when appropriate.
• Develop individualized plans of care focused on safety, chronic disease management, medication oversight, independence, and quality of life.
• Recommend and coordinate home health, therapy, PCP and specialist follow-up, durable medical equipment, in-home support, and community resources.
• Collaborate with hospitals, nursing homes, assisted living and memory care staff, physicians, and other medical providers on transitions of care.
• Communicate with attorneys, financial planners, Meals on Wheels, and other community partners.
• Conduct regular home or facility visits and update care plans as needs change.
• Provide emotional support, education, and counseling regarding diagnosis, prognosis, care options, and advance planning.
• Offer crisis intervention for falls, hospitalizations, sudden decline, and caregiver burnout.
• Meet with prospective clients, families, and referral sources to explain RN-led care management services.
• Provide back-up support to fellow Care Managers.
• Document assessments, care plans, communications, and interventions; track time for billing and communication.
• Participate in nursing and care management education, continuing education opportunities, and networking events.

Field Nurse Care Manager

Social Worker

• Manage a small caseload of private pay clients
• Provide coordination of services, resources and ongoing monitoring and management to clients in their home
• Help drive business and work with referral sources
• Develop strong relationships with Community and professional organizations that will generate client referrals
• Perform in depth client assessments including medical, psychosocial, environmental, financial, legal and family assessment
• Complete Fall Risk Assessment, Mini Mental Status Examination and Depression Screening for each client
• Recommend and coordinate all service needs for clients
• Work with client and family to develop plan of care to ensure client safety and all other needs are addressed
• Work with client, family, and professional staff to implement plan of care
• Collaborate with hospital, nursing home and AL/memory care staff, physicians and other medical providers, attorneys, financial planners, meals on wheels, and other professionals in geriatric service provider world
• Perform regular home visits to monitor client status, home environment or senior community
• Provide ongoing emotional support and counseling to the client and their family as needed
• Provide problem solving support to clients and fellow care managers as needed
• Provide crisis intervention and display critical thinking/problem solving skills
• Work with business development team to meet prospective clients, families and/or referral sources
• Provide back-up support to the GCM team as needed
• Carefully track and document time spent on each client to facilitate accurate billing
• Attend educational programs and networking events

Clinical Sales Representative

Social Work Care Manager, Patient Advocate, LSW/LCSW

Nurse Care Manager, Patient Advocate – RN

Field Nurse Care Manager

Medical Social Worker