- Provides Clinical Oversight of ECM Health Risk Assessments and determines if Member's Care Management needs are sufficient to be managed by a ECM Lead Care Manager or require the Consultant's intervention in the form of recommendations to implement in their Care Plan
- Participates in developing patient-centered care plans for the enrollees on their panel. Approves initial plan and biannual updates.
- Actively consults with Care Managers to review medical visit summaries, discharge papers, prepare for upcoming appointments, or review appointment outcomes
- Provides health and preventive care education for acute health conditions, chronic disease management, and medication monitoring.
- Engages vulnerable populations as part of a multidisciplinary outreach team. This includes home visits, accompaniment to appointments, outreach to hospitals, homeless shelters and other settings, as needed.
- Uses data to evaluate outcomes from targeted interventions for approximately 165 patients. Assists in developing appropriate adjustments to care plans based on this data.
- Helps to expand programming that addresses SDoH and enhances connections to community-based organizations
- Dedicate three days to program
- Work with Recuperative Care medical and case management teams, as need, to assist with client/patient centered care related to their Care Plan and health goals
- Work with all Medi-Cal Managed Care Plan Illumination Foundation ECM contracts among three Southern California regions: Los Angeles, Orange, and Inland Empire
- Works with hospitals to coordinate hospital admission/discharge plans with the behavioral health clinician, PCP, pertinent specialists and other organizations with the goal of preventing readmission, if possible
- Performs timely medication reconciliation following transitions in care. Supports medication adherence.
- Chart review and case conferences with ICMS PSH Case Managers
- Implements prevention & engagement activities
- Dedicate two days to ICMS PSH
- Engages in quality improvement efforts
- Valid Registered Nurse (RN) license in California, Psychiatric Mental Health Nurse Practitioner (PMH-NP), or PMH Clinical Nurse Specialist (PMH-CNS).
- Experience working with vulnerable populations, including persons with a history of trauma, those experiencing socioeconomic stress, homelessness, or substance use disorders
- Strong interpersonal skills and clinical problem solving
- Comfort working in an autonomous clinical setting and in an outreach setting
- Capability working with data to track and measure performance
- Basic computer skills, including the ability to send and receive emails and summarize data in spreadsheets.
- Valid CA Driver's License and eligibility for company vehicle insurance.
- Bachelor of Science in Nursing
- Care management experience
- Supervisory experience
- Bilingual in English and Spanish.
- Proficiency in Google Suite (Mail, Docs, Sheets, Calendar).
- Medical Insurance funded up to 91% by Illumination Foundation (Kaiser and Blue Shield), depending on the plan
- Dental and Vision Insurance
- Life, AD&D and LTD Insurance funded 100% by Illumination Foundation
- Employee Assistance Program
- Professional Development Reimbursement
- 401K with Company Matching
- 15 days vacation PTO/year
- 6 days sick PTO/year
- 10 days holiday PTO/year
- Potential eligibility for the Public Service Loan Forgiveness Program (PSFL) for federally qualified loans
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ECM Clinical Nursing Consultant - Cerritos, United States - Illumination Foundation
Description
Job Description
Job Description"Every person deserves compassion, dignity, and the safety of a place to call home."
Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care centers, emergency shelters, housing services and children's and family programs. IF currently has 13+ facilities with 22+ micro-communities scattered across Orange County, Los Angeles County and the Inland Empire.
Job Description
The Clinical Consultant is responsible for Clinical Oversight of ICMS PSH Case Managers and ECM Lead Care Managers to address the patient's medical and behavioral health needs, as well as social determinants of health. The Clinical Consultant will communicate directly with Case Managers and occasionally with patients via telephone, or during in-person, Interdisciplinary Care Team meetings (as needed), to discuss medication management/adherence, ensure appropriate follow up with Primary Care Provider, Behavioral Health Provider and other specialist(s). They will provide guidance during any emergency situations encountered by Case Managers. The Clinical Consultant will collaborate with the broader care team (PCP, BH clinicians, etc.) to provide client advocacy and ensure that the enrollees are receiving needed services and measuring progress towards the goals outlined in their patient-centered care plan.
The pay rate for this position is $100,000 - $130,000 per annum.
Responsibilities
As a clinical consultant within the ECM service:
As a clinical consultant within the ECM and ICMS PSH services:
Preferred Experience/Minimum Qualifications
Required:
Preferred:
Benefits
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