Case Mgr Assoc, High Rsk – Telework

Case Mgr Assoc, High Rsk – Telework

Job Type: Full Time / Flexi Time

Job Flexibility: Corporate Flexibility

Location Requirement: USA – Anywhere

General Area Of Expertise Required: Medical

Salary: Negotiable

Job Description: A Care Manager facilitates the achievement of patient wellness and autonomy through advocacy, assessment, planning, communication, education, resource management, and service facilitation. Based on the needs and values of the patient, in collaboration with all service providers, the care manager works to meet the individual’s broad spectrum of needs and incorporates the principles of the “The 6 Aims”:

· Coordination of Medical Care: content and appropriateness of medical care, including clinician involvement, access to care, coordination of care, process of care, follow-up and patient involvement · Self-Reliance: patient’s active participation in and responsibility for his/her own care · Daily Activity and Fitness: mobility and activity to the extent the clinical situation permits · Interdependence with Family and Friends: sustainable support and satisfying interactions with individuals close to the patient · Mental Challenge: interest in and pursuit of avocations, hobbies, reading and other passions · Community Involvement and Purpose: Participation in neighborhood affairs, current events, volunteerism, employment and/or spirituality

This position is responsible for negotiating comprehensive care plans with high-risk patients to improve functional status, promote self-reliance and prevent hospitalization. The CM reports to both a Leader Care Manager (LCM) and a Senior Director, Care Management Operations (SDCMO).

ESSENTIAL FUNCTIONS of a care manager utilizing the Nursing Process:

Assessment

The Care Manager works directly with patients and/or their designee, physicians and members of the health care team to assess the needs of high-risk patients by collecting in-depth information about the patient’s situation, individual needs and functional status and develop customized, proactive care plans. This includes, but is not limited to reference to the stages of changes and “The 6 Aims”.

Planning

· Is creative in formulating custom care plans from assessment and clinical information demonstrating the application of clinical guidelines which include standards of care.

· Establishes specific, measurable, attainable, relevant and time specific (SMART) nursing goals to guide the care planning process and promote self reliance.

Implementation

· Communicates regularly with patient and/ or designee and health care team consistent with patient acuity and functional status.

· Assesses patient progress towards established goals.

· Documents findings which facilitate communication regarding high-risk patients among care managers, physicians, and other healthcare professionals.

Coordination

· Communicates regularly with patient and/or designee and the health care team to provide consistent care, based on patient acuity and functional status.

· Identifies and aligns resources (such as, Education, Community and Fitness) that impact high-risk care.

· Assists patients in establishing, modifying or reinforcing a social support network, thereby promoting self-reliance.

· Negotiates for services in behalf of the high-risk patients.

Monitoring

· Communicates regularly with patient and/ or designee and health care team consistent with patient acuity and functional status.

· Monitors specific health actions and contracts with patients and health care team.

Evaluation& Outcomes

· Evaluates and documents efforts toward attainment of nursing and patient goals in the care planning process and modifies as necessary.

· Organizes and plans to present complex medical cases for team discussions which identify and trend strategies for innovative care management.

· Incorporates information learned into daily practice

Special Considerations

· Understands and utilizes the stages of change and adapts his/her communication style and care plan to align with the patient’s stage of change.

· Actively and creatively contributes to the work of the team of care managers.

· Facilitates conflict resolution among participants in the care planning process.

· Maintains patient privacy, confidentiality, safety, advocacy, and adherence to ethical/legal and accreditation/regulatory standards

Qualifications

QUALIFICATIONS (knowledge, competencies, skills and abilities):

Demonstrates:

· An excellent understanding and application of Healthways care management principles.

· Superior planning and organizational skills and ability to prioritize work in a dynamic environment.

· The ability to recognize the customer in all communications and interactions.

· An understanding of personal strengths and needs; seeks advice and assistance without hesitation.

· Ability to document clearly and concisely utilizing “Best Practices.”

· Practice within the scope of nursing licensure

· Knowledge of PC (Internet computer skills required).

· Innovation in patient management utilizing “The 6 Aims”.

EDUCATION/ RELEVANT EXPERIENCE:

· Current RN license required. BSN or advanced degree preferred. CCM encouraged.

· 3 years clinical practice experience; management of the chronically ill high-risk patient preferred.

POSITION EXPECTATIONS:

This position is eligible for telework. It requires working in a normal home office/office environment often with extensive use of the computer and extended sitting time. This position requires minimal lifting, up to 50 pounds with limited physical activity.

About Healthways:

For three decades, Healthways has been dedicated to improving the human condition. Each year, we learn more and do more for the millions of individuals who count on us to make a difference in their health and well-being. Healthways is a global provider of solutions that help employers, health plans and government agencies enhance business performance and reduce healthcare costs. Our mission is to create a healthier world, one person at a time.

Here at Healthways as we continue to make the world a healthier place, we have also created an environment where people choose to do their best work. Our unique culture thrives on mission-driven individuals who exude a high sense of energy and passion in everything that they do. Collaboration and teamwork are an essential part of everyday life for Colleagues who trust and depend on one another to achieve the highest degree of collective success. We are an organization that strives to recruit the best and the brightest individuals who take pride in the statement “I work for Healthways.”

Business Details:

Healthways

Apply Online: http://bit.ly/9RmRVw

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