Registered Nurse Outpatient Care Manager - PRN

Texas Health•Arlington, TX

9h•Remote

About The Position

The position will be responsible for the overall coordination of care, education, and care management of members enrolled in the care management and disease management programs. The position will support the Outpatient Care Management Department by managing the care needs of identified plan members with specific diseases. The position works in collaborative practice with the physician and other members of the health care team to meet member needs. The position will ensure tasks and projects are consistent with company strategy, commitments, goals, and timelines.The RN will possess the ability to effectively communicate with internal and external clients and maintain a positive attitude while working in a dynamic, fast paced environment. Effective caseload management of enrolled patients including patient assessment/education via telephone, and/or face-to-face for coordination of care, establishing patient-centered care plans, and transition planning across the continuum of care. Provides education and care management for members enrolled in the care management and disease management programs to achieve: (a) desirable/acceptable outcomes/responses, (b) perceptions of satisfaction or acceptance of those involved. Supports the Collaborative Care Management Model: Collaborating with physicians, social workers, pharmacists, and other professional staff to improve overall patient outcomes. Participate in interdisciplinary team conferences. Accountable for on-going compliance with the policies and procedures. This includes the standards of accrediting bodies and the regulations of state and local governing agencies (i.e., CMS, NCQA, and Nursing Practice Act Prioritize activities to achieve desired results; meet team goals by ensuring individual actions are aligned with the team's needs.

Requirements

Associates Degree in Nursing required
3 years Managed care and/or acute clinical care experience required or 3 years Case management experience required or 3 Disease management experience required
RN upon hire required

Nice To Haves

Bachelors degree in Nursing preferred
Utilization Management and pre-authorization experience preferred
CCM or ACM within 2 years of hire preferred

Responsibilities

Overall coordination of care, education, and care management of members enrolled in care management and disease management programs.
Manage the care needs of identified plan members with specific diseases.
Work in collaborative practice with physicians and other members of the healthcare team.
Ensure tasks and projects are consistent with company strategy, commitments, goals, and timelines.
Effectively communicate with internal and external clients.
Maintain a positive attitude in a dynamic, fast-paced environment.
Caseload management of enrolled patients including assessment/education via telephone and/or face-to-face.
Coordinate care, establish patient-centered care plans, and transition planning across the continuum of care.
Provide education and care management to achieve desirable/acceptable outcomes and perceptions of satisfaction.
Collaborate with physicians, social workers, pharmacists, and other professional staff to improve patient outcomes.
Participate in interdisciplinary team conferences.
Ensure ongoing compliance with policies, procedures, and standards of accrediting bodies and governing agencies (CMS, NCQA, Nursing Practice Act).
Prioritize activities to achieve desired results and meet team goals.