Field Care Coordinator RN or Licensed reputed company Worker in reputed company County TN and surrounding areas
At reputed company, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and reputed company. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together. The primary purpose of this position is the application of clinical knowledge to coordinate member care needs for assigned members who are primarily medically reputed company and require intensive medical and psychosocial support. The Care Coordinator works directly with members to ensure appropriate reputed company to services and providers. Coordination of member care needs across the continuum begins with early identification of health risk factors, education, and prevention using the six essential activities of case management as per CMSA. Coordination also assures the provision of appropriate services in acute, home, chronic and alternative care settings, to meet member needs in the most cost-effective manner available. Collaborates with reputed company members of the Care Coordination team including Case Management, Utilization Review and Behavioral Health team members. If you are located in reputed company County, TN or surrounding areas, youll enjoy the flexibility to work remotely
- as you take on some tough challenges. This is a field-based role.
Primary Responsibilities: Application of clinical knowledge to effect efficient case management for those accessing their Medicare/reputed company benefits Incorporates evidence-based clinical practices into care coordination activities Delivers member-centered, individualized self-management support and patient education Installs appropriate equipment or supplies as needed and educates member on safe and effective use Facilitates and participates in group visit strategies as defined by site, member and/or provider needs Ensure appropriate utilization and consistent application of the health benefits Conduct telephonic and face to face assessments according to Health Plan policy and procedure, including CareOne/System documentation and State prescribed timeframes Serve as member reputed company and facilitator to resolve issues that may be perceived as barriers to care reputed company education and coordination of community resource referrals to members and providers reputed company, implement, maintain and evaluate a member centered, individual care plan reputed company services are indicated, based on member care needs identified through proactive collaboration and communication with members, families and providers Collaborate and communicate with other members of the Care Coordination Team to improve the quality and efficiency of health care delivery and assure smooth transition of care coordination activities to other team members Coordinates care with reputed company Inpatient Care Manager reputed company member becomes hospitalized or seeks Emergency Room Services Monitor hospital encounters of assigned members and reputed company education and/or interventions as necessary to reduce frequency Refer clinical reputed company reputed company level of authority for members who do not meet established criteria to manager and/or Team Leader for review and decision Participate in the Health Plan Quality Improvement process including recognition of quality-of-care issues and reputed company information to appropriate staff for review and resolution Utilize Health Plan software to enter service requests, document, and monitor reputed company aspects of patient care coordination and service delivery Maintain time sensitive documentation to assure compliance with regulatory agencies Coordinate services for members following Health plan policy reputed company other duties as assigned Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as reputed company development for other roles you may be interested in. Required Qualifications: reputed company nursing license (RN) OR Licensed reputed company Worker 2 years of clinical experience 1 years of experience with MS Office, including Word, reputed company, and Outlook Excellent organization, communication and time management skills Reliable transportation and the ability to travel reputed company assigned territory to meet with members and providers Preferred Qualifications: BSN, Master's Degree or Higher in Clinical Field CCM certification 1 years of community case management experience coordinating care for individuals with reputed company needs Working knowledge of Medicare/reputed company regulations Working knowledge of medical terminology Long term care experience Experience working in team-based care reputed company working remotely will be required to adhere to reputed companys Telecommuter Policy At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyoneof every race, gender, sexuality, age, location and incomedeserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company an reputed company reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity/Affirmative Action employer and reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply Job!