Case Manager RN Health Leaders Network at FMOLHS

DescriptionThe Case Manager 1 directs the utilization review of patient charts treatment plans and discharge planning pertaining to the quality of care and treatment criteria for patients in a specific department. The Case Manager 1 specializes in the review of information pertaining specifically to the assigned areas. Relies on education experience professional training and judgment to accomplish responsibilities. A wide degree of creativity and latitude is expected. Works under minimal supervision.ResponsibilitiesIndividual High Risk Care Management Assists health plan member to set realistic goals using system tools and judgement. Gain trust to assure disease based high risk or high utilization individuals set and meet or exceed targets.Consistently measures and communicates with the individual on goal status and documents progress and measures of improvement using system tools. Process includes constant communication psycho-social skills and disease management care plans such as obesity diabetes and hyperlipidemia.Coordinates care team around individual to assure obstacles to goals are removed including such activities as making appointments assuring prescriptions are filled directing care to physicians specialists EAP or other providers.Uses system tools to monitor identify and facilitate in the closing of gaps in care and collaborates with members encouraging compliance in order to achieve health status goalsProvider collaboration Communicates effectively with the provider to assure that the panel of individuals is on track with health goals.Monitors care plans including outcomes for measurement of disease wellness and other goals.Member satisfaction Ensures that services provided to members maintains or improves member health status optimizes benefits available within health plan and improves overall patient satisfaction of services deliveredQualificationsExperience - 3 years of general or specialty nursing practiceEducation - See licensure requirementsLicense & Cert - Current Louisiana State RNRequired Experience:Manager Key Skills Project Portfolio Management,Motivational Interviewing,HIPAA,Computer Skills,Intake Experience,Lean Six Sigma,Conflict Management,Case Management,Team Management,Program Development,Social Work,Addiction Counseling Employment Type : Full Time Experience: years Vacancy: 1