Care Manager RN WFH

HCA•Overland Park, KS

36d•Remote

About The Position

The Care Manager supports the patient and primary care relationship through care delivery enhancement. Primary mechanisms for this support are telephonic outreach to patients to guide them through transitions of care, care management, preventive services, and self-management. The Care Manager acts as an integral member of the division Care Coordination team supporting PSG primary care providers and practices in successfully meeting quality improvement initiatives in assigned division(s). This role is remote but requires visiting onsite with the practices as needed and the ability to attend office meetings. Candidates must be in Kansas City or surrounding areas (or be planning to relocate).

Requirements

Graduate of an accredited college of nursing
Knowledge of value based care and care management experience (CM)
Active Compact RN License or current licensure as an RN in the state of Kansas and Missouri.

Nice To Haves

Outpatient clinic nursing experience preferred (AWV)

Responsibilities

Serves as a subject matter expert in quality and value-based care programs such as MIPS, ACOs, and payor pay-for-performance contracts. Assists in educating practice staff on quality, payor, and government program requirements
Develops professional working relationship with HCA/PSG primary care providers, practice managers, and their staff to collaboratively manage follow-up care and improve overall health and wellness
Attends learning sessions and shares information learned with team members
Assists in the development of tools, education and workflow processes to assist the division(s) in meeting CMS, ACO, documentation, and payor quality initiatives
Collaborates with interdisciplinary teams and leaders (PSG, Payer Contracting & Alignment, Quality and Payor Initiatives) to achieve the organization's coordination of care goals, quality goals, and financial performance goals
Conducts in-person and virtual meetings with practice managers, staff, providers and managers to communicate program goals, results, and provide education
Maintains the strictest confidentiality in the areas of patient, employee, and physician relations
Practices and adheres to the "Code of Conduct" philosophy and "Mission and Value Statement"
Acts as a patient advocate to facilitate appropriate care management and wellness activities
Performs related work and additional duties as requested by supervisor
Monitors patient compliance with preventive screening and/or behavioral health management processes using internal and payor reporting tools
Accesses portals as necessary to prepare reports and other documents to evaluate progress and prioritize workload
Communicates via telephone and other virtual tools with patients regarding care needs, documenting communications appropriately in the electronic medical record
Prepares and maintains patient charting as needed and performs medical record reviews for payor projects
Contacts patients after hospital discharge to identify the need for a follow-up appointment, community resource needs, etc.
Documents assessment in the medical record to support transition of care services as specified by CMS and other program requirements
Triages patients to determine those appropriate for medical and/or behavioral care management
Creates a care management action plan with the patient/caregiver that includes elements of self-management, as appropriate
Identifies and enrolls eligible patients in longitudinal or chronic care management for medical or behavioral health conditions
Oversees the execution of patient care plans in partnership with Care Coordinators
Facilitates specialty referrals, as appropriate, for conditions/needs managed outside the primary care realm
Documents efforts in accordance with established workflow protocols
Identifies and engages community resources to assist patients as needed
Assists with practice and provider empanelment processes
Schedules appointments related to preventive care, chronic disease management, and/or integrated behavioral health
Prepares and maintains care coordination reports and provides periodic updates to practice leaders and providers
Conducts wellness campaigns for targeted, focus areas

Benefits

Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
Free counseling services and resources for emotional, physical and financial wellbeing
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
Employee Stock Purchase Plan with 10% off HCA Healthcare stock
Family support through fertility and family building benefits with Progyny and adoption assistance.
Referral services for child, elder and pet care, home and auto repair, event planning and more
Consumer discounts through Abenity and Consumer Discounts
Retirement readiness, rollover assistance services and preferred banking partnerships
Education assistance (tuition, student loan, certification support, dependent scholarships)
Colleague recognition program
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.