Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
Note
Candidate must have Compact RN License.\
Day To Day Responsibilities
Outreaching member to enroll them in CM program.
Building care plans, medication review, assessments care plans
Describe the performance expectations/metrics for this individual and their team:
20 calls/day
Tell Me About What Their First Day Looks Like
System-specific training
Education/Experience
Graduate from an Accredited School of Nursing.
Bachelor’s degree in Nursing preferred.
2+ years of clinical nursing experience in a clinical, acute care, or community setting.
Knowledge of healthcare and managed care preferred.
Licenses/Certifications:
Compact RN license.
Responsibilities
Develop, assess, and adjust, as necessary, the care plan and promote desired outcome.
Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short- and long-term goals, treatment, and provider options.
Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio-economic needs of clients.
Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs.
Provide patient and provider education.
Facilitate members’ access to community-based services.
Monitor referrals made to community-based organizations, medical care and other services to support the members’ overall care management plan.
Actively participate in integrated team care management rounds.
Identify related risk management quality concerns and report these scenarios to the appropriate resources.
Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems.
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Industries
Staffing and Recruiting
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