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CASE MANAGER RN - POPULATION HEALTH CLINICAL SERVICES

Apply Email Job Current employees click here Job ID PRO0021R Date posted 12/04/2018

Job Description

Position:  Case Manager- RN

Summary:

The Case Manager provides ongoing outreach and focused care management services for a diverse population of high priority, complex patients. Individualized patient education around disease prevention, chronic disease management, care transitions, and health plan benefits is provided. This position works collaboratively as a member of an interdisciplinary team of professionals responsible for optimizing the patient care plan. Develops effective relationships with in-network, out-of-network practices and care team members to improve care coordination and patient outcomes. Accountable for achieving productivity, quality, and cost containment targets.

Responsibilities include:
  • Identifying needs and planning training and development programs to ensure consistent population health and care management processes.
  • Ensures clinical competency and skills assessment is completed annually for clinical staff. Provides support for staff that require remediation or additional training to achieve compliance.
  • Develops training programs consistent with evidenced based guidelines and status of staff.
  • Works in collaboration with Quality Improvement to establish documentation standards, recommended workflows, and policies and procedures for clinical staff.
  • Identifies quality improvement initiatives, and works collaboratively with practice staff to establish goals to improve clinical outcomes. 
  • Responsible for maintaining current skills through self-development and relevant education. Identifies trends and responds proactively to changes in the health care market place.
  • Maintains compliance with governmental and regulatory agencies, including CMS and commercial insurers.
Accountable for consistently achieving productivity and quality metrics. 
Employees eligible for $5,000.00 Recruitment Bonus based on meeting productivity targets.

Qualifications

Education and Experience:


Associate Degree; BSN preferred. 
Two years of clinical experience in a health care setting caring for patients with complex medical conditions. 
Experience in case management, utilization review or quality improvement highly desirable. 
BLS required

Primary Location: Morrisville, North Carolina, United States

Department: UPN1-10032-POP HEALTH CLINICAL SERVICES

Shift: Day Job

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