RN Care Manager
Company: Wellvana Integration Partners, LLC
Location: Nashville
Posted on: May 2, 2024
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Job Description:
Description:The healthcare system isn't designed for health.
We're designed to change that. We're Wellvana, and we help doctors
deliver life-changing healthcare. Through our elevated value-based
care programs, we're revitalizing an antiquated system that's far
too long relied on misaligned incentives that reward quantity of
care not the quality of it. Our enlightened approach-covering
everything from care coordination to coding to marketing- ties the
healthy outcomes of patients directly to healthier earnings for
primary care providers. Providers in our curated network keep their
independence, reduce their administrative headaches, and spend more
time with patients. Patients, in turn, get an elevated experience
with coordinated 24/7 care that is nothing short of life changing.
Recently named by Insider as one of 33 startups investors expect to
take off in 2023, we're one of the fastest-growing healthcare
companies in America because what we do works. This is the way
medicine is meant to be. We're looking for a Registered Nurse (RN)
Care Manager with a compact license to remotely manage the holistic
needs of rising risk and high-risk patients, to streamline the
quality and delivery of care and improve health outcomes. The RN
Care Manager operates as an extension of Wellvana partner practices
and health systems to support an assigned panel of patients
identified for additional support or those recently discharged
after an Emergency Department visit or Inpatient stay. The RN Care
Manager will advocate for the patient and help navigate the health
care system via targeted interactions and coordination with their
primary care provider. The RN Care Manager will monitor each
patient's progress to their assigned care plan and assess
concerns/barriers, available resources and support and social
determinant of health needs. The RN Care Manager will leverage
multidisciplinary care team members (Licensed Clinical Social
Workers, behavioral health specialists, Medical Assistants,
Pharmacists and Pharmacy Technicians, etc) to provide personalized
and comprehensive care and support, educate the patient on their
conditions and opportunities for improvement, and to resolve
identified patient needs and barriers. This is an extremely
rewarding role for an RN looking to build strong relationships and
have a life changing impact on patient health. The Role: We're
looking for a Registered Nurse with a compact license who embraces
change and is not afraid of a challenge. The RN Care Manager is
responsible for managing rising risk and high-risk members to
promote effective education, self-management support, and timely
healthcare delivery to achieve optimal quality and financial
outcomes. The RN Care Manager will formulate and implement a care
management plan that addresses the members identified needs by
assessing concerns/barriers, resources, and care goals. The RN Care
Manager will advocate for the member and support the member in
navigating the health care system via ongoing engagement.?When
applicable, the RN Care Manager will work collaboratively with the
interdisciplinary care team and the member's primary care provider
to identify and support the achievement of the member's short-term
and long-term health goals. The RN Care Manager provides education
and resources to members and/or responsible parties, to reduce
preventable emergency room visits, hospitalizations, and
re-admissions.? What you'll do: Telephonically engage assigned
patients to specified cadence and frequency based on healthcare
status and need. Build relationships and trust to support the
patient and assist them as they navigate the healthcare ecosystem
Enroll patients in designated programs based on chronic conditions
or recent events (discharges from Emergency Department or Inpatient
facilities) Ensure patient adherence to assigned care plans and
prescribed medications Coordinate with aligned practices to ensure
timely visits and follow-ups based on protocols for chronic
condition and discharge management, close care gaps, and monitor
timely refills to medications Perform whole-person assessments for
identified individuals. This includes physical, social determinants
of health, and psychological barriers and concerns for members as
appropriate. Leverage multi-disciplinary team members to address
and resolve issues Identify problems or gaps in care and offer
opportunity for intervention Collaborate as needed with providers,
and other healthcare team members including inpatient case
management staff and outpatient providers, to transition and
facilitate care across the healthcare continuum to optimize
clinical and financial outcomes.? Cooperate with appropriate health
care team members to perform root cause analysis on readmissions.?
Provide insights and recommendations for hospice and palliative
eligible patients.? Implement a member-centric care management
plan, utilizing SMART goals, that address practitioner care goals,
member/family concerns and available resources. Provide ongoing
evaluation of the effectiveness of the plan of care in meeting
established care goals through collaboration with the affiliated
practice, patient, and/or family-caregivers. Revises the plan of
care as needed to reflect changing needs, issues and goals and
monitors and evaluates the progress of the member at prescribed
minimal intervals.? Maintain accurate and timely documentation.
Ensures documentation meets current standards and policies.? Meet
established goals for productivity including panel size,
enrollment, retention, quality and standard call center metrics.?
Maintain a working knowledge of, and adheres to applicable federal
and state regulations including, but not limited to, laws related
to patient confidentiality, the release of information, and HIPAA.
Abide by the organization's compliance program and requirements.?
Maintain appropriate clinical licensure in good standing.?
Participate in regular team meetings and peer review activities.
Participate in departmental and organizational committees, as
applicable. Assist/support in the orientation of new personnel.
Promote collaborative teamwork.? Meet with care management
leadership team and the care management/clinical coordination team
on a regular basis to provide member updates identify issues and
develop strategies for resolution. Maintain appropriate
professional boundaries.? Interact respectfully and effectively
with others, focusing upon the achievement of organizational goals
and objectives through a commitment to teamwork. Appropriately
update departmental leadership with necessary information.? Utilize
teach back methods with patient/caregiver Support training of new
telephonic staff members.? Perform other duties as
needed.Requirements:Education Associates degree in nursing
required? BSN Preferred? Licensure/Certification ?Must hold a
current/active TN compact RN license? Required Experience Minimum
two years of nursing-related care experience?preferably in a
primary care office or call center setting Case Management, Care
Management, Care Coordination, telephone nursing management, and/or
Disease Management experience? Location & Shift? Team members will
be based out of the headquarters location in Green Hills, TN. As
performance metrics are achieved and maintained, there is
opportunity for hybrid work Shifts may vary? Required Knowledge,
Skills, and Abilities Knowledge of care management concepts along
the continuum of care? Advanced clinical knowledge of chronic
disease states? Motivational and behavioral interviewing Experience
and ability to use Microsoft Office products and word-processing
software daily? Excellent written, verbal, and listening
communication abilities. Communicate appropriately and clearly to
members, coworkers, and providers Ability to manage conflict,
stress, and multiple simultaneous work demands in an effective and
professional manner Ability to successfully articulate the process
of attaining goals and outcomes of care management? Ability to
apply clinical knowledge and experience in a care management role?
Ability to care to manage diverse populations without applying
one's own personal values? Ability to think critically and
analytically and work with minimal supervision within the nursing
scope of practice.? Ability to evaluate and appropriately respond
to verbal and non-verbal communication from patients in diverse
stages of development? PI4de75bc67d3b-25660-34306752
Keywords: Wellvana Integration Partners, LLC, Nashville , RN Care Manager, Executive , Nashville, Tennessee
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