Central Health

RN Case Manager

Req No.
2021-5138
Company
Sendero Health Plans
Job Locations
US-TX-Austin | US-TX-Austin
Category
Hidden (21636)
Type
Temporary Full-Time

Overview

Under the general direction of the Manager of Case Management, this nurse case manager identifies, screens, tracks, monitors and coordinates the care of members with multiple co-morbidities and/or psychosocial needs. The position has frequent or daily needs access to confidential information and protected health information. Other duties as assigned.

Responsibilities

Essential Duties (at least 5 that are non-negotiable duties and are absolutely pertinent to successfully completing the job without accommodations):
• Complete a comprehensive physical, medical, and psychological assessment on high risk high cost patients via telephonic interview.
• Establish care plan, goals, interventions, and contact schedule based on risk category, and patients/family members identified medical and social needs
• Promote compliance with disease specific clinical outcomes by providing each individual with self-management supports including disease specific education materials, nutritional recommendations, exercise/activity, signs/symptoms to watch for and report to your MD, and Care plan and treatment goals including self-management goals
• Coordinate care and communication between multiple providers, medical, nursing, social, and behavioral health.
• Must be able to independently travel off-site to various locations.

 

Knowledge/Skills/Abilities:
• Clinical knowledge in the treatment of injuries, diseases and deformities including symptoms, treatment alternatives, drug properties and interactions and preventive health guidelines.
• Working knowledge of Case Management principles and processes
• Experience in Medicaid Managed Care including STAR and CHIP.
• Experience with Commercial, Health Care Exchange Programs and other county programs.
• Ability to manage workload efficiently and effectively and within established policies and procedures.
• Excellent interpersonal skills with the ability to interface and interact effectively with members, providers, health plan staff and other external customers.
• Strong verbal, listening and written communication skills including detail oriented and concise documentation skills.
• Knowledge of HHSC, TDI, NCQA and HEDIS regulations, standards, or measures to assure overall compliance with all standards.
• Working knowledge in the use of a personal computer and of Microsoft Office products including Word, Excel, Outlook, and Power Point.

 

People Management/Department Management/Business Unit Management:
• Develops, implements, monitors, and evaluates the case management health risk assessment and nursing plan of care as outlined in policies and procedures
• Interacts and collaborates with the interdisciplinary care team to review clinical assessment and update nursing care plans
• Serves as an advocate and clinical resource for members and their families by providing constructive information regarding their disease process and available resources to minimize problems and increase customer satisfaction
• Performs non-invasive home and/or in-patient assessments to include medication reconciliation, education, and home safety evaluation
• Coordinates with internal and external social services agencies, contracted providers, and programs to ensure that members receive needed and timely services across the continuum of care
• Attends staff development educational training to support professional growth
• Maintains compliance with all regulatory standards
• Identifies improvement opportunities and maintains quality standards
• Performs other duties as assigned

Qualifications

MINIMUM EDUCATION: Completion of an accredited Registered Nursing Program
PREFERRED EDUCATION: Bachelor’s degree in nursing or health related field
MINIMUM EXPERIENCE:
• 3 years of experience in community health setting, public health, chronic disease management, community nursing, case management
• Experience in care coordination and disease management/education
• Experience working with primary care providers in practice setting to coordinate care and disease management
• Strong communication skills, both verbal and written
• Knowledge of case management, disease management, and chronic care principles
PREFERRED EXPERIENCE:
REQUIRED CERTIFICATIONS/LICENSURE:
1. Active and unrestricted state Registered Nursing License in good standing

PREFERRED CERTIFICATIONS/LICENSURE:
1. All Sendero Case Managers will be expected to obtain their Commission for Case Manager Certification (CCMC) OR American Nurses Association Nursing Case Management Certification (ACMA) within 3 years of hire

Options

Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed