Nurse Care Manager - Baton Rouge, United States - Louisiana Primary Care Association

    Louisiana Primary Care Association
    Louisiana Primary Care Association Baton Rouge, United States

    1 month ago

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    Full time
    Description
    Louisiana Primary Care Association

    Position Description    Position Title: Nurse Care ManagerFull-time ExemptSupervisor: Director of Managed Care and Network Development
    Position Summary: The Nurse Care Manager is responsible for developing patient care plans while providing patient education, guidance, and support, as well as maintaining a comprehensive care plan.
    Responsibilities:
    • Help close AWV gaps.
    • Utilize patient information with the goal of achieving 4-star level performance in each medication adherence measure.
    • Use nursing assessment skills to help guide care decisions while working collaboratively with an interdisciplinary care team to provide supportive care to patients.
    • Outreach to patients to schedule annual wellness visits.
    • Ensure that medical services are managed effectively and that the plan of care addresses the clinical condition and psychosocial needs of patients to maximize the goals of care.
    • Monitor patient progress against plan of care goals with an emphasis on patient care needs during transitions and health changes.
    • Manage transitions of care and other care management services.
    • Support contracted provider care management team on the use of payer analytics and reporting and incorporate contracted provider's internal analytical tools into pre-visit planning to improve gap closure at AWVs.
    • Work directly with contracted providers and attributed members to removing barriers to filling medications appropriately.
    • Work on other HEDIS campaigns in coordination with the contracted provider's care management team.
    • Work closely with the Health Plan Quality Practice Advisor in the coordination of activities to meet STAR goals.
    • Provide feedback to providers on risk-adjustment and quality coding opportunities, in coordination with contracted provider coders.