20,068 Care Management jobs in the United States

**Job Overview**
This .8 position supports the inpatient peds units at Masonic Children's Hospital. The Patient Care Management Coordinator provides comprehensive care coordination of patients as assigned. The care coordinator assesses the patient's plan of care and develops, implements, monitors, and documents the utilization of resources and progress of the patient through their care, facilitating options and services to meet the patient's health care needs. The intensity of care coordination provided is situational and appropriate based on patient need and payer requirements. This position is accountable for the quality of clinical services delivered by both them and others and identifies/resolves barriers which may hinder effective patient care. This position has responsibility to determine how to best accomplish functions within established procedures, consulting with leader on any unusual situations. Internal customers include all levels of nursing management and staff, medical staff, and all other members of the interdisciplinary health care team. External customers include physicians and their office staff, payers, community agencies, provider networks, and regulatory agencies.
**Responsibilities**
+ Manages patients across the health care continuum to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
+ Acts as one point of contact for patients, physicians, and care providers throughout the patient's hospitalization.
+ Initiates/implements transition functions and activities for patients communicating with patients, families, and the health care team to ensure seamless transitions.
+ Assesses patient admissions and continued stay utilizing evidence-based criteria.
+ Contributes to the development and implementation of individualized patient care plans.
+ Collaborates with health care team partners and patients/family to manage the patient discharge plan.
+ Effectively communicates the plan across the continuum of care.
+ Assist in the development and implementation of process improvement activities to achieve optimal clinical, financial and satisfaction outcomes.
+ Enables efficiency in care by identifying and reducing delays, ensuring appropriate level of care, facilitating length of stay reductions, and identifying resources to promote a safe and effective discharge.
+ Collects data and other information required by payers to fulfill utilization and regulatory requirements.
+ Identify and communicate, to appropriate leader, all issues related to case escalation.
+ Establishes a collaborative relationship with physicians, medical directors, nurses and other unit staff, and payers.
+ Demonstrates effective communication by being a critical link with attending and consulting physicians and all health care team members and payers. Facilitates resolution to any identified issues.
+ Mentors internal members of the health care team on case management and managed care concepts.
+ Understands and focuses on key performance indicators.
+ Actively tracks outcomes and participates in quality planning.
+ Facilitates integration of concepts into daily practice.
**Required Qualifications**
+ Bachelors Degree in Nursing
+ 1 year RN experience
+ Registered Nurse
**Preferred Qualifications**
+ Case Management Nurse
+ Basic Life Support (American Heart Assoc, Red Cross)
**Benefit Overview**
Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: Disclaimer**
The posted pay range is for a 40-hour workweek (1.0 FTE). The actual rate of pay offered within this range may depend on several factors, such as FTE, skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization values pay equity and considers the internal equity of our team when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored.
**EEO Statement**
EEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status

Hourly Pay Range:

$32.60 - $48.90 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.

Position Highlights:

• Position: Care Management Specialist
• Location: LOH Corp Center- Warrenville, IL
• Full Time 30 hrs
• Hours: 9pm-7:30am

A Brief Overview:
Reviews the clinical needs of customers seeking behavioral health services and provides treatment referrals which are consistent with the customer's medical and psychiatric status/symptoms. Is in constant review of where patients are in the system who need inpatient behavioral health beds or services and works to place them in clinically appropriate in system beds. This role works to connect the behavioral health service line across the NS-EEH health system.

What you will do:

• Reviews comprehensive clinical assessments for patients seeking treatment within the NS-EEH Behavioral Health Service line.

• Appropriately identifies clinical needs. Obtains initial diagnostic impression and confirmation during the disposition process with the physician or designee.
• Reviews vital signs, weight, blood alcohol and calibration of BMI for specific population.
• Reviews documentation of assessment and level of care determined.
• Reviews collateral with families and support
• Provides treatment referrals which are consistent with the customer's medical and psychiatric status and symptoms.
• Formulates clinical picture of the patient to collaborate with the Clinical Team on admissions and appropriate placement.
• Ensures smooth patient admissions and movement by collaborating with BH Leadership.
• Collaborates and creates working relationships with NS-EEH acute care ED and medical floor staff to ensure smooth workflows and patient movement between the hospitals

What you will need:

• Master's Degree in a health-related field or a Bachelor's Degree in Nursing
• Current State of Illinois licensure LSW, LCSW, LPC, LCPC, RN
• Minimum of three years of acute care behavioral health experience.

Benefits (For full time or part time positions):

• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, Pet and Vision options
• Tuition Reimbursement
• Free Parking
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. For more information, visit

When you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.

Please explore our website ( to better understand how Endeavor Health delivers on its mission to "help everyone in our communities be their best".

Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.

Hourly Pay Range:
$32.60 - $48.90 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.

Position Highlights:

• Position: Care Management Specialist
• Location: LOH Corp Center- Warrenville, IL
• Full Time 30 hrs
• Hours: 9pm-7:30am

A Brief Overview:
Reviews the clinical needs of customers seeking behavioral health services and provides treatment referrals which are consistent with the customer's medical and psychiatric status/symptoms. Is in constant review of where patients are in the system who need inpatient behavioral health beds or services and works to place them in clinically appropriate in system beds. This role works to connect the behavioral health service line across the NS-EEH health system.

What you will do:

• Reviews comprehensive clinical assessments for patients seeking treatment within the NS-EEH Behavioral Health Service line.

• Appropriately identifies clinical needs. Obtains initial diagnostic impression and confirmation during the disposition process with the physician or designee.
• Reviews vital signs, weight, blood alcohol and calibration of BMI for specific population.
• Reviews documentation of assessment and level of care determined.
• Reviews collateral with families and support
• Provides treatment referrals which are consistent with the customer's medical and psychiatric status and symptoms.
• Formulates clinical picture of the patient to collaborate with the Clinical Team on admissions and appropriate placement.
• Ensures smooth patient admissions and movement by collaborating with BH Leadership.
• Collaborates and creates working relationships with NS-EEH acute care ED and medical floor staff to ensure smooth workflows and patient movement between the hospitals

What you will need:

• Master's Degree in a health-related field or a Bachelor's Degree in Nursing
• Current State of Illinois licensure LSW, LCSW, LPC, LCPC, RN
• Minimum of three years of acute care behavioral health experience.

Benefits (For full time or part time positions):

• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, Pet and Vision options
• Tuition Reimbursement
• Free Parking
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. For more information, visit

When you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.

Please explore our website ( to better understand how Endeavor Health delivers on its mission to "help everyone in our communities be their best".

Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.

Our team members are the heart of what makes us better.
At **Hackensack Meridian** **_Health_** we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community.
Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.
The **Care Management, Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for coordinating, communicating, and facilitating the clinical progression of the patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay, promote efficient utilization of resources and ensure that care meets evidence-based practice standards and regulatory/payor requirements and follows the state of New Jersey regulations for Nursing.
**Education, Knowledge, Skills and Abilities Required** :
+ BSN or BSN in progress and/or willing to acquire within 3 years of hire or transfer into the position
+ Effective decision-making skills, demonstration of creativity in problem-solving, and influential leadership skills.
+ Excellent verbal, written and presentation skills
+ Moderate to expert computer skills
+ Familiar with hospital resources, community resources, and utilization management
**Licenses and Certifications Required** :
+ NJ State Professional Registered Nurse License.
+ AHA Basic Health Care Life Support HCP Certification.
**Licenses and Certifications Preferred:**
+ Certified Case Manager (CCM), Certified Clinical Medical Assistant (CCMA), or American Case Management Association (ACMA) certification strongly preferred.
If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!

Minimum rate of $111,924.80 Annually
HMH is committed to pay equity and transparency for our team members. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package.
The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted hourly rates may be stated as an annual salary in the offer and posted annual salaries may be stated as an hourly rate in the offer, depending on the level and nature of the job duties and credentials of the candidate. The base compensation determined at the time of the offer may be different than the posted rate of pay based on a number of non-discriminatory factors, including but not limited to:
+ Labor Market Data: Compensation is benchmarked against market data to ensure competitiveness.
+ Experience: Years of relevant work experience.
+ Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training.
+ Skills: Demonstrated proficiency in relevant skills and competencies.
+ Geographic Location: Cost of living and market rates for the specific location.
+ Internal Equity: Compensation is determined in a manner consistent with compensation ranges for similar roles within the organization.
+ Budget and Grant Funding: Departmental budgets and any grant funding associated with the job position may impact the pay that can be offered.
Some jobs may also be eligible for performance-based incentives, bonuses, or commissions not reflected in the starting rate. Certain positions may also be eligible for shift differentials for work performed on evening, night, or weekend shifts.
In addition to our compensation for full-time and part-time (20+ hours/week) job positions, HMH offers a comprehensive benefits package, including health, dental, vision, paid leave, tuition reimbursement, and retirement benefits.
HACKENSACK MERIDIAN HEALTH (HMH) IS AN EQUAL OPPORTUNITY EMPLOYER
All qualified applicants will receive consideration for employment without regard to age, race, color, creed, religion, sex, sexual orientation, gender identity or expression, pregnancy, breastfeeding, genetic information, refusal to submit to a genetic test or make available to an employer the results of a genetic test, atypical hereditary cellular or blood trait, national origin, nationality, ancestry, disability, marital status, liability for military service, or status as a protected veteran.

Summary

JOB SUMMARY

Responsible for coordinating continuum of care and discharge planning activities for a caseload of assigned patients; develops plans of care and discharge plans, monitors all clinical activities, makes recommendations for alternative levels of care, and identifies cost-effective protocols. Care Management provides Care Coordination, Compliance, Transition Coordination, and Utilization Management.

DUTIES & ESSENTIAL JOB FUNCTIONS

NOTE: The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.

* Coordinates all utilization review functions, including response to payor requests for concurrent and retrospective review information including Medicare and MediCal regulations/requirements, avoidable days and quality issues. Applies Medical necessity criteria to determine level of care.
* Assures clinical interventions are appropriate for the admitting diagnosis and Level of Care that reflects the standard of care, as defined by the medical staff and the organization; identify inappropriate admit status based on identified criteria and ensures the patient is registered at the appropriate level of care. Utilizes McKesson Interqual clinical guidelines; refers questionable cases to the CM Manager or physician advisor for determination.
* Takes appropriate action when cases do not meet criteria. Escalates to the attending physician, and the Care Management physician advisor of any concurrent denials.Prepares case reports;documents treatment plan, progress notes and discharge summary related information as required by Medicare, MediCal, Title 22 and other mandated regulations according to Department standards.Reassesses the patient's condition when changes occur and revises the care plan when appropriate.
* Develops, evaluates, and coordinates a comprehensive discharge plan in conjunction with the patient/family, physician, nursing, social work, and other healthcare providers and agencies. Completes an initial assessment within 24 hours of admission and documents findings in the electronic health record. Processes referrals and authorizations that adhere to federal, state and local insurance regulatory agencies and offer patient choice per regulation.
* Identifies potential problems prevents and or resolves barriers to the discharge plan. Along with the social work team member
* Mobilize resources to effect rapid and timely movement of the patient through system to achieve targeted discharge times established by AHS.
* Identifies and mobilizes patients and family strengths to optimize use of healthcare and community resources. In coordination with patient and family wishes, guide/assist in securing needed post discharge services
* Collaborates with Care Management teams (i.e. Care Transition team and CM teams at other facilities) for high risk patients for timely follow-up appointments and confirms prior to discharge that complex patients are appropriately linked to community services.
* Provides community resource education and coaching, focusing on individual patient self-management principles. Ensures continuity of care through communication in rounds and written documentation, level of care recommendations, transfer coordination, discharge planning and obtaining authorizations/approvals as needed for outside services for the patient.
* Communicates with physicians and multidisciplinary health team members to provide continuity of care, supporting and maintaining the multidisciplinary team approach to ensure effective resource utilization and appropriate level of care.
* Makes independent assessments and recommendations regarding course of action in complex situations.
* Confirm all applicable department and regulatory targets for department performance process improvements are attained (e.g., re admissions, throughput, LOS).

QUALIFICATIONS

Required Education: Associate Degree in Nursing

Preferred Education: Bachelor's of Nursing

Preferred Education: Master's in Nursing

Required Experience: Three years of acute care nursing

Preferred Experience : Medical/surgical or critical care experience; broad clinical background. Within the last 3 years, experience in Case Management in an acute setting or utilization review at a medical group or health plan.

Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California, Active BLS - Basic Life Support Certification issued by the American Heart Association; other advanced life support certifications may be required per unit/department specialty according to patient care policies; CPI -Crisis Prevention Intervention Training (required for all positions at John George Psychiatric Pavilion; and certain positions in the Emergency Department).

Preferred Licenses/Certifications: Certification in Case Management, CCMC or ACM. Bilingual Preferred.

PAY RANGE

$89.32 to $131.08 per hour

The pay range for this position reflects the base pay scale for the role at Alameda Health System. Final compensation will be determined based on several factors, including but not limited to a candidate's experience, education, skills, licensure and certifications, departmental equity, applicable collective bargaining agreements, and the operational needs of the organization. Alameda Health System also offers eligible positions a generous comprehensive benefits program.

Summary

SUMMARY: Responsible for coordinating continuum of care and discharge planning activities for a caseload of assigned patients; develops plans of care and discharge plans, monitors all clinical activities, makes recommendations for alternative levels of care, and identifies cost-effective protocols. Care Management provides Care Coordination, Compliance, Transition Coordination, and Utilization Management.

DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE: The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.

1. Coordinates all utilization review functions, including response to payor requests for concurrent and retrospective review information including Medicare and MediCal regulations/requirements, avoidable days and quality issues. Applies Medical necessity criteria to determine level of care.

2. Assures clinical interventions are appropriate for the admitting diagnosis and Level of Care that reflects the standard of care, as defined by the medical staff and the organization; identify inappropriate admit status based on identified criteria and ensures the patient is registered at the appropriate level of care. Utilizes McKesson Interqual clinical guidelines; refers questionable cases to the CM Manager or physician advisor for determination.

3. Takes appropriate action when cases do not meet criteria. Escalates to the attending physician, and the Care Management physician advisor of any concurrent denials.Prepares case reports;documents treatment plan, progress notes and discharge summary related information as required by Medicare, MediCal, Title 22 and other mandated regulations according to Department standards.Reassesses the patient's condition when changes occur and revises the care plan when appropriate.

4. Develops, evaluates, and coordinates a comprehensive discharge plan in conjunction with the patient/family, physician, nursing, social work, and other healthcare providers and agencies. Completes an initial assessment within 24 hours of admission and documents findings in the electronic health record. Processes referrals and authorizations that adhere to federal, state and local insurance regulatory agencies and offer patient choice per regulation.

5. Identifies potential problems prevents and or resolves barriers to the discharge plan. Along with the social work team member

6. Mobilize resources to effect rapid and timely movement of the patient through system to achieve targeted discharge times established by AHS.

7. Identifies and mobilizes patients and family strengths to optimize use of healthcare and community resources. In coordination with patient and family wishes, guide/assist in securing needed post discharge services

8. Collaborates with Care Management teams (i.e. Care Transition team and CM teams at other facilities) for high risk patients for timely follow-up appointments and confirms prior to discharge that complex patients are appropriately linked to community services.

9. Provides community resource education and coaching, focusing on individual patient self-management principles. Ensures continuity of care through communication in rounds and written documentation, level of care recommendations, transfer coordination, discharge planning and obtaining authorizations/approvals as needed for outside services for the patient.

10. Communicates with physicians and multidisciplinary health team members to provide continuity of care, supporting and maintaining the multidisciplinary team approach to ensure effective resource utilization and appropriate level of care.

11. Makes independent assessments and recommendations regarding course of action in complex situations.

12. Confirm all applicable department and regulatory targets for department performance process improvements are attained (e.g., re admissions, throughput, LOS).

MINIMUM QUALIFICATIONS:

Required Education: Associate Degree in Nursing

Preferred Education: Bachelor's of Nursing

Preferred Education: Master's in Nursing

Required Experience: Three years of acute care nursing

Preferred Experience : Medical/surgical or critical care experience; broad clinical background. Within the last 3 years, experience in Case Management in an acute setting or utilization review at a medical group or health plan.

Required Licenses/Certifications: Active licensure as a Registered Nurse in the State of California, Active BLS - Basic Life Support Certification issued by the American Heart Association; other advanced life support certifications may be required per unit/department specialty according to patient care policies; CPI -Crisis Prevention Intervention Training (required for all positions at John George Psychiatric Pavilion; and certain positions in the Emergency Department).

Preferred Licenses/Certifications: Certification in Case Management, CCMC or ACM. Bilingual Preferred.

Nemours is seeking a Registered Nurse to join the Care Management team! The Care Management RN is a member of the Complex Management Care Team and will coordinate team-based care to provide health services and education to patients and families through effective partnerships with Nemours Primary Care Physician practices, the Diagnostic Referral Department (DRS), medical professionals and community resources. Provides care coordination to the medically complex population by utilizing critical thinking skills and nursing expertise in order to optimize patient outcomes for designated populations. Works with patients and families to ensure both medical and psychosocial needs are met to promote health and well-being. Addresses gaps in care and promotes timely access to appropriate care, increasing the utilization of preventative care and healthy behaviors to improve the health of the population at risk.

The Care Management RN is accountable for adherence to policies and procedures of Nemours Children's Health, Delaware Valley and other affiliated hospitals to which Nemours-delegated patients are admitted/seek care. The Care Management RN is expected to maintain all state and federal clearances for DE.

Responsibilities:

* Assists with the identification of patients within the Nemours Primary Care Physician practices, Diagnostic Referral Department, other specialty teams and medical professionals who require care coordination assistance as related to chronic care needs, needs related to Social Determinants of Health (SDOH), and coordination of services.
* Identifies patient and family gaps in care and/or barriers to care and patient/family strengths and assets. Identify patients at risk for poor transitions, high Emergency Department utilization and/or readmission to hospital. Will complete a comprehensive transition assessment and plan for on-going touchpoints for these patients. Will communicate needs and plans to providers, care team, outpatient care coordinators and care managers if referral is indicated.
* Initiates family contacts and facilitates patient access to, and communication between physicians and other team members.
* Works cooperatively with families, patients, other members of the treatment team, social service agencies, community resources, and public agencies. Collaborates with the family and team to arrange for health care needs. Acts as a liaison for agencies and families with identified healthcare needs.
* Utilizes the nursing process to coordinate the care of an identified population of pediatric patients throughout the healthcare continuum.
* Assists families and patients through the healthcare system by acting as patient advocate and navigator connecting patients to relevant community resources with the goal of enhancing patient health and wellbeing.
* Serves as point of contact, advocate and informational resource for family, patient, care team, school systems and their school nurses, community resources, and state agencies. Facilitates meetings/calls between patient /family, care team, payors, and outside agencies as needed.
* Collaborates with providers, case managers, social workers and related care teams to understand care, treatment goals and overall plan of care.
* Educates patient/family about a condition (existing or newly diagnosed) to assist them in appropriate self-management.
* Participates in data collection, health outcomes reporting, clinical audits, and program evaluation. Assists with the identification of areas for improvement within their practice.
* Monitors specialty consults and follows up if patient/family did not follow through with the appointment or the consult report was not received by the PCP.
* Makes appropriate referrals to case managers and care managers.
* Makes appropriate referrals to home care, durable medical equipment (DME), and pharmacy vendors. Provides after visit summaries and other pertinent information related to on-going care in the home or placement.

Qualifications:

* Bachelor of Science in Nursing is required
* Active Delaware or compact RN license required
* Case Management Certification: CCM, ACM-RN is preferred

Description

Job Summary and Qualifications

The Care Management AWV RN supports Annual Wellness Visits (AWV) for the assigned clinics within the division. The Care Management AWV RN 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). The Care Management AWV RN demonstrates critical thinking skills, scientific judgment, and leadership in the anticipation and planning for the care of the patient. The Care Management AWV RN will support other duties assigned around Value Based Care Support as needed.

This role is clinic based 5 days a week, Monday-Friday day shift hours.

Duties & Responsibilities:

General

* 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

Annual Wellness Visits

* Schedule Annual Wellness Visits (AWV) for assigned practice
* Perform the AWV in the clinic setting in conjunction with the provider/s
* Ensure patients are completing their annual preventive exams and addressing open care gaps

Care Gaps

* 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

Transitions of Care

* 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

Population Health

* 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

EDUCATION & EXPERIENCE

* Graduate of an accredited college of nursing
* Outpatient clinic nursing experience preferred
* Active Compact RN License or current licensure as an RN in the state of Kansas and Missouri

Benefits

Statland Medical Group offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

* 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.



Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

Come join our team as a(an) Care Management AWV RN. We care for our community! Just last year, HCA Healthcare and our colleagues donated 13.8 million dollars to charitable organizations. Apply Today!

Supporting HCA Healthcares 186 hospitals and 2,400+ sites of care, Physician Services plays a crucial role as the main entry point for patients looking for high-quality healthcare within the HCA Healthcare system. With a focus on meeting the needs of our patients at all access points, Physician Services is dedicated to implementing innovative, physician-driven, value-added solutions to assist physicians in providing high-quality, patient-centered care, aligning with our mission to care for and enhance human life.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times.  In recent years, HCA Healthcare spent an estimated 3.7 billion in costs for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"The great hospitals will always put the patient and the patients family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Care Management AWV RN opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.