Chronic Condition Case Manager, RN

🕒 Janeiro 15

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MedWatch, LLC

SiteLinkedInTodas as Vagas

201 - 500 funcionários

Fundada em 1988

⚕️ Seguro de Saúde

🤝 B2B

Healthcare Insurance • B2B

A MedWatch, LLC é uma empresa de serviços de saúde que oferece gestão de utilização, gestão de casos, gestão de doenças, defesa do membro e coordenação de cuidados concierge para pagadores, TPAs e empregadores auto-segurados. Há mais de 35 anos, entrega soluções de gestão de cuidados orientadas clinicamente, precertificação e soluções de sinistros, contratação direta e serviços complementares apoiados por certificações URAC e tecnologia proprietária interna para melhorar os resultados clínicos e reduzir os custos do plano e do membro.

Descrição

• The Chronic Condition Case Manager will have direct responsibility for managing an individual caseload using Complex and Chronic Condition Management constructs. • This individual is expected to accurately service and satisfy customers by responding to customer inquiries, communicate benefit and healthcare questions/answers. • Collect and document patient information to facilitate the initial assessment and formulation of an initial plan of care. • Continuously gather, update and review information to include (but not limited to) collecting medical records, history, assessment information. • Guide, coach and encourage the patient in following the plan of care. • Instruct the participant regarding both short and long-term goals and offer guidance as to how to meet those goals. • Document actions taken and interventions provided throughout the process. • Collaborate with providers, payers, and participants to ensure that the participant has access to appropriate resources. • Maintain documentation in the computer system. • Complete all aspects of case in the computer. • Prepare timely reports to the payer to summarize case actions, the results of those actions, and the continuing disease management plan. • Maintain billing as appropriate in computer system.

🎯 Requisitos

• Minimum of three years of clinical experience including at least two years of chronic disease management and patient teaching in any setting preferred. • Registered Nurse (current unrestricted, in state of practice). • Good keyboarding skills and computer literacy preferably with Microsoft Office applications and with internet. • Must be fluent in English. • Good organizational skills and time management • Excellent verbal and written communication skills. • Ability to handle difficult situations tactfully and diplomatically. • Effective problem solving and decision-making skills. • Strong computer skills with proficiency in MS Office Suite products (Word, Excel, PowerPoint).

🏖️ Benefícios

• paid time off • medical • dental • vision • short and long-term disability • life insurance • AD&D • 401k with match • critical illness coverage • legal plan • identity theft coverage • pet insurance • discount programs