WVU-Disease Management Coordinator -70168

WVU Medicine

170d

About The Position

The Disease Management Coordinator collaborates with patients and primary care providers to ensure patients receive quality, efficient, and cost-effective healthcare services. Coordinates, monitors, and evaluates all options and services to optimize a patient’s health status.

Requirements

• Associate’s Degree in Nursing AND Seven years clinical experience in a healthcare setting OR Bachelor’s Degree in Nursing AND Five years clinical experience in a healthcare setting.
• West Virginia licensure as a Registered Professional Nurse or licensure as Registered Professional Nurse in another state with a temporary West Virginia practice permit.
• West Virginia state criminal background check required, and Federal, if applicable, for DHHR BMS regulated area.
• Obtain certification in Basic Life Support within 30 days of hire date.

Nice To Haves

• Bachelor’s Degree in Nursing.
• Prior care coordination experience.

Responsibilities

• Ambulatory Utilization Management, Financial Management and Quality Screening for assigned patients.
• Identifies the targeted population and risk stratifies all patients to prioritize needs and direct interventions.
• Communicates and collaborates with inpatient and outpatient case management to implement the discharge plan and coordinate a safe transition to the next level of care.
• Works in collaboration with physicians/providers, patients, and their families to ensure safe and efficient transitions of care.
• Works collaboratively with patients to design an individualized plan of care that ensures coordination of services by the healthcare team.
• Collaborates with available social services for appropriate resource and financial management which may include, but is not limited to financial assistance coordination/referrals, entitlement program coordination/referrals, patient benefit coordination, assessment for appropriate usage of Health Care Resources/clinical cost efficiency.
• Coordinates/facilitates patient progression throughout the continuum, Transitional Planning, Advocacy and Education.
• Clinical performance improvement, outcome management and quality activities.
• Uses data to drive decisions and plan/implement performance improvement strategies for assigned patients, including fiscal, clinical and patient satisfaction data.
• Implements clinical interventions based on risk stratification and evidence-based clinical guideline adherence and promotes best practice by initiating/adjusting therapies as directed by the practitioner and providing appropriate follow-up monitoring as needed.
• Coordinates appropriate laboratory and diagnostic testing.
• Continuously evaluates laboratory results, diagnostic tests, utilization patterns and other metrics to monitor quality and efficiency results for assigned population.
• Participates in development, implementation, evaluation and revision of clinical pathways and other tools.
• Educates the multidisciplinary team and physicians about clinical pathways/protocols and managed care principles.
• Works with leadership to design, implement, and evaluate a centralized care model that optimizes value.
• Monitors clinical and financial indicators on an ongoing basis and takes action to achieve continuous improvement in both areas.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees