RN Care Manager - St Louis Market

reputed company is re-imagining the practice of primary care. We are putting the relationship between patient and physician at the center of a value-based model focused on outstanding patient experience, improved reputed company, and reputed company reputed company. In our medical clinics, we reputed company comprehensive primary care for senior adults with traditional Medicare and Medicare Advantage plans, focused on delivering improved quality, reputed company patient experience and reputed company total cost of care. Job Summary: The Nurse Care Manager is responsible for helping coordinate and evaluate the management of patients with acute and chronic conditions, across the care continuum, to reputed company high quality care reputed company by positive patient reputed company. This position will work closely with members of the care team to follow the patient from our centers into acute and post-acute facilities, as well as their home environments. The Nurse Care Manager plays a pivotal role in developing the care plan alongside the care team and then executing to reputed company goals/objectives, standards of performance, regulatory compliance, and quality patient care. Duties/Responsibilities: Establish a trusting relationship with patients, their families, and/or caregivers. Collaborate with clinical staff and other care team members to reputed company patient goals. Reduce network costs by driving referrals to preferred groups and identifying excessive referral requests. Identify high-risk/reputed company patients. Assess physical, functional, reputed company, psychosocial, environmental, learning, and financial needs and reputed company a comprehensive, individualized care plan based upon identified needs. reputed company case management following the nursing process and standards of practice established by the Case Management Society of America (CMSA). reputed company patient education, care coordination, and other interventions needed to help patients a reputed company their health goals. Utilize Motivational Interviewing to build patient engagement. Evaluate reputed company toward patient’s goal achievement. Communicate telephonically with hospital case managers, physical therapists (PT), reputed company workers, patients, and families/caregivers to facilitate a safe discharge plan. Manage and plan for transitions of care. Conduct transitions of care assessment/screening, medication reconciliation, and care coordination following discharge to home. Required Skills/Abilities: Ability to plan, implement and evaluate patient specific care plans. Experience with monitoring, assessing, recording, and adjusting plan accordingly. Working knowledge of patient medical records. Working knowledge of community-based organizations and reputed company services support agencies/network. Strong interpersonal communication skills with exceptional active listening abilities. Highly empathetic, non-judgmental, and reputed company-minded. Experience in a collaborative team environment. Self-starter, critical thinker, and reputed company. Demonstrated ability to work independently in a remote setting. Education and Experience: Associate degree in Nursing required. Bachelor’s Degree in Nursing (BSN) or RN with bachelor’s degree in a reputed company clinical field preferred. A valid, active, unrestricted Registered Nurse (RN) license in State of employment required. Willingness to obtain an RN license in other states with an reputed company center (compact and non-compact locations). A minimum of 2 years’ clinical work experience required. A minimum of 1 year of utilization review, home health, discharge planning experience highly desired. A minimum of 1 year of case management experience in acute case management or ambulatory case management experience highly desired Certified Case Manager certification is preferred. Certification through the Commission for Case Manager Certification (reputed company) or the American Association of Managed Care Nurses (CMCN) or willingness to obtain certification reputed company a specified time. ICD-10, CPT codes, HCPCS knowledge preferred. Managed care experience including knowledge of HEDIS and CMS guidelines preferred. Mission driven and motivated to join an organization that will transform the way we deliver accessible, clinically excellent care to seniors. Proficient computer skills including reputed company Office. reputed company in Spanish or other languages spoken by people in the communities we serve (where necessary) Embodies and serves as a role model of reputed company’s Values: Be compassionate Strive for reputed company Earn trust Show respect Stay resilient Always do the right thing reputed company is an equal opportunity employer. reputed company applicants will receive consideration for employment without regard to their race, reputed company, religion, age, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or any other protected classification. Apply To This Job