RN Care Manager - Tucson, AZ and Las Vegas, NV

ArchWell Health•Las Vegas, NV

4d•Remote

About The Position

ArchWell Health is re-imagining the practice of primary care. We are putting the relationship between patient and physician at the center of a value-based model focused on outstanding patient experience, improved access, and better outcomes. In our medical clinics, we provide comprehensive primary care for senior adults with traditional Medicare and Medicare Advantage plans, focused on delivering improved quality, better patient experience and lower total cost of care.

Requirements

Associate degree in Nursing required.
A valid, active, unrestricted Registered Nurse (RN) license in State of employment required.
A minimum of 2 years’ clinical work experience required.
Proficient computer skills including Microsoft Office.

Nice To Haves

Bachelor’s Degree in Nursing (BSN) or RN with bachelor’s degree in a related clinical field preferred.
Willingness to obtain an RN license in other states with an ArchWell Health center (compact and non-compact locations).
A minimum of 1 year of utilization review, home health, discharge planning experience highly desired.
A minimum of 1 year of case management experience in acute case management or ambulatory case management experience highly desired.
Certified Case Manager certification is preferred.
Certification through the Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) or willingness to obtain certification within a specified time.
ICD-10, CPT codes, HCPCS knowledge preferred.
Managed care experience including knowledge of HEDIS and CMS guidelines preferred.
Mission driven and motivated to join an organization that will transform the way we deliver accessible, clinically excellent care to seniors.
Fluency in Spanish or other languages spoken by people in the communities we serve (where necessary).

Responsibilities

Establish a trusting relationship with patients, their families, and/or caregivers.
Collaborate with clinical staff and other care team members to achieve patient goals.
Reduce network costs by driving referrals to preferred groups and identifying excessive referral requests.
Identify high-risk/complex patients.
Assess physical, functional, social, psychosocial, environmental, learning, and financial needs and develop a comprehensive, individualized care plan based upon identified needs.
Perform case management following the nursing process and standards of practice established by the Case Management Society of America (CMSA).
Provide patient education, care coordination, and other interventions needed to help patients achieve their health goals.
Utilize Motivational Interviewing to build patient engagement.
Evaluate progress toward patient’s goal achievement.
Communicate telephonically with hospital case managers, physical therapists (PT), social workers, patients, and families/caregivers to facilitate a safe discharge plan.
Manage and plan for transitions of care.
Conduct transitions of care assessment/screening, medication reconciliation, and care coordination following discharge to home.