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The Care Manager RN 1 QA will be responsible for assessing and coordinating patient care across the continuum, utilizing accepted criteria and guidelines to manage benefits and determine medical necessity of services provided. This position will function as a clinician, case manager, and educator to achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization.
Location: Frisco, TX - This position sits onsite in the clinic
Setting: Telephonic Case Management
Schedule: Full TIme - Monday - Friday - Onsite at the clinic. Candidate must report to the office every day.ESSENTIAL FUNCTIONS OF THE ROLEAssesses plans, implements, documents, coordinates, monitors, evaluates and updates the plan of care by collaborating with all members of the health care team to provide evidenced based care.Establishes patient care management plans, interventions, treatment goals and self-management goals.Assesses the health care, educational and psychosocial needs of the patient and family.Assists patients with self-management through education, visits and telephonic engagement; encourages and supports patient adherence to their care plans.Researches, evaluates and recommends resources to meet medical and non-medical needs of patients and families. Collaborates, refers and communicates across all programs to ensure appropriate coordination of services.Researches and takes an active role in identifying problems and possible solutions in the coordination of care to determine most appropriate setting.Acts as liaison to hospitals, primary care providers, post-acute partners and specialists.KEY SUCCESS FACTORSSpecialty Certification strongly encouraged.Knowledge of care management, resource and utilization management.Skilled in care management and patient assessments.Excellent verbal and written communication skills required.Ability to monitor, assess and record patient progress against a plan of care.Ability to facilitate patient access to community resources.Ability to work collaboratively with both internal and external medical staff and external partners and organizations.Ability to assess, adapt, and calmly respond to changing and crisis environment.Ability to maintain confidentiality with all aspects of patient information in accordance with all applicable policies and regulations.BENEFITSOur competitive benefits package includes the following- Immediate eligibility for health and welfare benefits- 401(k) savings plan with dollar-for-dollar match up to 5%- Tuition Reimbursement- PTO accrual beginning Day 1Note: Benefits may vary based upon position type and/or level
For more information, please call 1-888-491-8833 Ext. 1896 (Extension Required) or e-mail firstname.lastname@example.org
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