RN Care Navigator/Case Manager (100% Remote for candidates located in the PST &
职位总结注册护士，护理导航员/案例管理人员将负责针对脏健康管理的具体情况管理。护理导向者将完成持续治疗活动，以促进和促进高质量，经济效率的患者结果，并专注于整个病人和护理提供协调。管理混合敏性成员的设置案例，审查和/或获取会员数据并进入 HealthMap 护理管理文档系统，完成健康检查，药物调整，创建和维护会员中心的护理计划，更新已确定的问题，障碍，干预措施以及目标以及持续案件管理的协助。护理导航将与内部和外部 （医生，护士和其他卫生保健人员）合作以确保患者积极的结果和护理协调。责任 ·处理进出电话向我们的成员提供世界级服务 · 通过教育成员关于透析和移植选择的类型，培养脏健康及相关同病性疾病以及优化脏替代疗法 · 参与 HealthMap 脏卫生计划 · 根据复杂性和政策顺序跟踪会员 · 作为患者倡导者应对并解决问题或障碍 · 在护理规划中利用社区资源和方案 · 作为医生，患者支持网络，治疗医生和其他辅助提供商之间的联系人，作为跨学科护理团队成员协调护理，解决护理问题和帮助病人实现个性化目标。·根据政策通知服务提供者；·遵守 HIPAA 隐私法和其他联邦，州和地方规定。·遵守公司定义的运营政策和程序。·遵守企业安全政策。·负责个人指标和关键性能指标，并由组织确定。·导航技术应用 - Excel,OneNote,Outlook 和 Word · 支持经营时间后和不同时区根据业务需求 · 照顾患者和家庭，并提供自主管理要求 · 需要活跃的无限制的 RN 许可证 · 学士学位；可考虑6年以上 RN 经验，包括3年以上案例管理
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Position Summary
The Registered Nurse, Care Navigator/Case Manager will be responsible for case management specific to kidney health management. The Care Navigator will complete activities for the continuum of care to facilitate and promote high quality, cost-effective outcomes for patients and focus on the whole patient and care delivery coordination. Managing a set caseload of mixed acuity members, reviewing and/or obtaining member data and entry in HealthMap’s Care Management documentation system, completing member health and social determinants of health screenings, medication reconciliation, creation and maintaining member-centric care plans, updates of identified problems, barriers, interventions, and goals and assistance with ongoing case management. The Care Navigator will collaborate with internal and external (physicians, nurses, and other healthcare personnel) to assure positive patient outcomes and care coordination.
Responsibilities
- Handle in and outbound calls delivering world-class service to our members
- Educate kidney health and related co-morbid conditions as well as optimizing renal replacement therapy by educating members on the types of dialysis and transplant options
- Engage members into HealthMap’s Kidney Health Program
- Follow up with members based on complexity and cadence by policy
- Serve as patient advocate for responding and working to resolve concerns or barriers
- Utilize community resources and programs in care planning
- Serve as liaison between the patient, the patient’s support network, treating physician, and other ancillary providers as a member of an interdisciplinary care team to coordinate care, resolve nursing problems and assist patients in meeting individualized goals
- Notify providers of identified patient needs based on policy
- Comply with HIPAA privacy laws and all other federal, state, and local regulations
- Comply with company-defined operational policies and procedures
- Comply with company security policies
- Accountable for individual metrics and key performance indicators and identified by the organization
- Navigate technical applications - Excel, OneNote, Outlook, and Word
- Support after hours and various time zones based on business need
- Drive patient and families in their own care and to support self-management
Requirements
- Active, unrestricted RN license required
- Bachelor’s degree required; 6+ years of RN experience including 3+ years in case management may be considered in lieu of degree
- CCM preferred
- Three (3) years of experience in case management preferred
- Experience working with nephrology or cardiology patients preferred
- Experience with Medicare and Medicaid preferred
Skills
- Advocate and energize a culture of collaboration, positivity, and motivation
- Strategic thinking and planning
- Deliver effective communication – verbal and written
- Succeed in a challenging environment with changing priorities
Travel
No Travel
Originally posted on Himalayas