- Engage telephonically with members, caregivers, and providers to develop a comprehensive plan of care, identify key strategic interventions, and address the members needs at various stages along the care continuum.
- Assess the member's ongoing care needs and progress towards goals throughout the plan duration and make revisions as needed to address changes in the member's condition, lack of progress toward goals of the care plan, preference changes, and transitions in care settings. Coordinates plan of care with goals of member stabilization, decreased admissions, medication management, behavior change and ability to self-manage.
- Coordinate patient education in support of standards of care guidelines and related health issues using the most appropriate modality for the member.
- Identify relevant benefit and community resources, evaluates Social determinants of Health and facilitates referrals based on member need.
- Perform medication reconciliation at the onset of care plan, after changes in health status, and every thirty days during the life cycle of the care plan, assessing for efficacy and drug interactions/side effects.
- Facilitate and monitor the transition of care which involves moving the member from one healthcare practitioner to another as their healthcare needs change. Implements and oversees the agreed upon plan of care as well as coordinates member follow-up post discharge.
- Utilize established documentation standards to maintain quality of care plan documentation to include member progress toward their established state of being and barriers to achievement of care plan objectives and outcomes.
- Abide by Value Based Care Management Program Description and Guidelines.
- Complete mandatory training.
- Successfully partner with all levels of administrative and professional personnel.
- Ability to extrapolate information from a variety of sources including medical records to create concise records that accurately depict the medical "story" of the member.
- Proficiency with data analysis and ability to organize data in support of reporting needs.
- Ability to proactively identify and assimilate quality improvement processes into practice.
- Experience with medically oriented care plan documentation.
- Training in motivational interviewing preferred.
- Minimum 3-5 years clinical experience in any of these areas: acute care, home health, physician office management, managed care organization, provider relations, pharmaceutical sales.
- Demonstrates computer competencies to include word processing, spreadsheet, presentation preparation, and database management. Demonstrated ability to learn customized computer applications.
- Maximize all technology inclusive of Microsoft Teams, Microsoft Word, Microsoft Excel, Microsoft Outlook, laptop computers, and all other relevant unified communication technologies.
- This position will be based from a home office which must satisfy all HIPAA requirements.
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Registered Nurse
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Cape Fox Corporation Rockville, United StatesShare this job as a link in your status update to LinkedIn. · Job Title · Registered Nurse-EHOMS · Job Description · Eagle Health LLC is seeking a qualified RN to join our team supporting NIH providing Occupational care. · This · position · will · support · the · NIH · Occu ...
Care Manager, Registered Nurse - Rockville, MD, United States - Sharecare
Description
Care Manager, Registered Nurse - RemoteSharecare is the leading digital health company that helps people - no matter where they are in their health journey - unify and manage all their health in one place.
Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers, health plans, government organizations, and communities optimize individual and population-wide well-being by driving positive behavior change.
Driven by our philosophy that we are all together better, at Sharecare, we are committed to supporting each individual through the lens of their personal health and making high quality care more accessible and affordable for everyone.
The Care Manager supports the implementation of the CareFirst Value Based Care Management program by working with CareFirst members.The Care Manager partners with members, caregivers and the interdisciplinary care team to ensure members have an effective plan of care and positive member experience that leads to improved health outcomes.
The Care Manager will advocate, guide and intervene on behalf of their members to ensure successful completion of member goals, while providing Complex Case Management and strategies for health self-management through the duration of the care plan.
Research and identify members with acute and complex health conditions.Note:
The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
Qualified applicants will receive consideration for employment without regard to race, color, sex, national origin, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law.
Qualified applicants will receive consideration for employment without regard to race, color, sex, national origin, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law.
