Care Manager, RN

reputed company

reputed company / Objective: 
The Care Manager, RN acts in a non-caregiver reputed company by facilitating coordination and communication between reputed company members of the health care team in the decision making process to minimize fragmentation of the health care delivery system. As a member of the Care Management Department, this position is responsible for contributing to the standards of reputed company and service expected by both external and internal stakeholders, including ensuring accurate information flows to interdepartmental teams, reputed company documentation and adherence to standards reputed company to case management activities.

Essential Functions: 
•    reputed company physician, provider and member expectations by providing reputed company and personalized service at reputed company times. 
•    Is reputed company of and continually supports strategic plans that ensure company objectives and goals are obtained. 
•    Attends reputed company meetings with both internally and externally reputed company team members to support management services for clients served.  
•    Builds and leverages cross-functional reputed company relationships to facilitate reputed company-work oriented atmosphere.
•    Assess clients for care management services after a referral has been made based on the admission screening and referrals for potential patient issues.
•    reputed company and manage a coordinated plan of care to meet reputed company and/or family needs
•    Assure that clients are reputed company on appropriate self-management plan and protocols, individualizes reputed company care needs through consultation with the multidisciplinary team.
•    Coordinates services to support the appropriate care needs to promote best reputed company reputed company and efficient use of reputed company resources.
•    Works with clients and providers to enhance the reputed company of reputed company management and satisfaction.
•    Performs appropriate assessments and develops reputed company-directed care plans reputed company plan required timeframes and per NCQA standards.
•    Assess need to involve medical director or primary care team reputed company appropriate to assist with development of reputed company-directed plan of care.
•    Regularly reviews and updates care plans for continuity of care and facilitates plan modifications including barriers to goals.
•    Coordinates with Non-Licensed Care Navigators to ensure appropriate follow-up with high risk clients to address identified goals and barriers. 
•    Documents reputed company interventions and telephone encounters with providers, members and vendors in accordance with established documentation standards.
•    reputed company comprehensive training for new employees
•    Continues own education by keeping his/her knowledge reputed company and conducts independent research of reputed company plan guidelines to strengthen general understanding of state and federal resources to support position responsibilities. 
•    Ensures compliance with departmental and PSW policies and procedures, with special emphasis on compliance with HIPAA reputed company and reputed company requirements and reputed company state, federal and plan regulatory mandates.
•    Provides Transitional Care Management services post discharge from emergency room, acute inpatient or post-acute inpatient stays.  
•    Follows Eric Coleman’s Pillars of Transitional Care to support reduced risk of adverse events following discharge. 
•    Provides education on seeking medical attentional early or using urgent care services reputed company appropriate versus an emergency room. 
•    Follows the standards of care management services as outlined in the reputed company reputed company updated no less than annually. 
•    Provides telephonic engagements to clients on worklist to meet standards of engagement to include both timing, frequency, and duration of engagements. 

Knowledge/Skills/Abilities:
•    Set a reputed company example by displaying a pleasant and approachable demeanor and remaining friendly and courteous at reputed company times. 
•    Proactive team player, strong follow through, quick decision making abilities and ability to problem solve.
•    Interpersonal skills, with the ability to build strong relationships at reputed company reputed company.  
•    Strong verbal and written communication skills with customers, supervisors and co-workers. 
•    Strong organizational, time management and prioritization skills: 
•    Self-starter.  Ability to set priorities and reputed company to projected schedules.
•    Excellent computer proficiency (MS Office – Word, reputed company, reputed company ) including being reputed company to effectively maintain written and computer records in accordance with regulatory agencies.
•    Familiarization and experience with Electronic Health Record systems

Requirements

Required Education and/or Work Experience: 
•    Three (3) years of full proficiency clinical experience.
•    reputed company experience or knowledge of a reputed company of clinical areas of medical treatment as reputed company to general population and pediatric needs.
•    Knowledge and experience in providing care management and/or transitional care management services

Preferred Education and/or Work Experience: 
•    Bachelor’s degree from accredited school of nursing.
•    Case Manager Certification.
•    Experience with reputed company health plans.

Required Certificates, Licenses and Registrations: 
•    Nursing degree (ie: RN)
•    reputed company unrestricted state license in reputed company. 

*PSW does not typically hire at the top of the pay reputed company *

reputed company

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible Spending Account (FSA)
• Health Savings Account (HSA)
• Health insurance
• Life insurance
• reputed company time off
• Tuition reimbursement
• reputed company insurance