Care Coordinator Nurse

Care Coordinator Nurse

Seeking a Nurse (LPN/RN) or Licensed Certified Social Worker (LCSW) to provide Chronic Care Management and Care Coordination to patients with multiple chronic conditions. The Care Manager is responsible for performing telephonic Care Management, including clinical assessments, patient education based on conditions, and early symptom identification. This role includes working with patients as well as resources provided to develop an ever-evolving and comprehensive care plan included but not limited to care coordination and referral services.

Responsibilities:

• Completing all referrals sent from CM during members preferred time– address barriers, assess member needs and align to appropriate goal/intervention work
• Provide robust health teaching from industry experience in alignment to policy/procedures, use evidence-based materials – communicate resources outside of Healthwise / departmental approved websites to leadership for approval
• Complete documentation in alignment with policy/procedures
• Facilitate care coordination – referral to other specialist CM, collaboration with physicians/health care insurance plan/community resources, etc.
• Address patient concerns/complaints – report to leadership
• Identifies opportunities that impact quality goals and recommends process improvements
• Apply critical thinking skills and problem-solving techniques to the chronic care management process.
• Maintain current knowledge of disease processes, resources, and treatment options available.
• Meet performance goals based on part-time or full-time hours.
• HIPAA compliant use of computer access to facilitate patient care.
• Use care plan to guide patient interaction and direction.
• Review individual care plans and make monthly phone calls to CCM enrolled patients.
• Manage the flow of information to and from the provider’s office.
• Assists in the assessment of patient needs and health by taking patient history, medication listing, and assessing patient’s physical and mental status.
• Completes all necessary documentation in the patient’s medical record in accordance with the practice’s charting policy.

Requirements:

• Perform bedside patient services 1-2 times/per week in Skilled Nursing Facilities
• Understanding of medical terminology.
• Understanding of documentation required for Chronic Care Management.
• Ability to understand and carry out written, oral and/or graphic instructions.
• Ability to multi-task, manage details and organize efficiently and effectively.
• Ability to interact with patients, medical and administrative staff, and the public effectively.
• EMR experience
• Intermediate proficiency with computers and telephone use
• Positive and proactive attitude; team player!
• Goal orientated
• Must be punctual and have reliable transportation
• Must have a valid form of certification and/or license

Job Type: Full-time

Pay: $15.00 - $35.00 per hour

Benefits:

• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Experience:

• Customer service: 1 year (Preferred)

Work Location: Multiple Locations