Chronic Condition Case Manager, RN

🕒 vor 4 Monaten

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MedWatch, LLC

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201 - 500 Mitarbeiter

Gegründet 1988

⚕️ Krankenversicherung

🤝 B2B

Healthcare Insurance • B2B

MedWatch, LLC ist ein Dienstleistungsunternehmen im Gesundheitswesen, das Utilization Management, Fallmanagement, Krankheitsmanagement, Mitgliedervertretung und Concierge-Betreuung für Kostenträger, TPA (Third Party Administrators) und selbstversicherte Arbeitgeber anbietet. Seit über 35 Jahren liefert das Unternehmen klinisch orientiertes Versorgungsmanagement, Präzertifizierung und Schadenregulierung, direktes Vertragsmanagement und ergänzende Dienstleistungen, unterstützt durch URAC-Akkreditierungen und eigene In-House-Technologie, um klinische Ergebnisse zu verbessern und die Kosten für Pläne und Mitglieder zu senken.

Beschreibung

• 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.

🎯 Anforderungen

• 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).

🏖️ Vorteile

• 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