Disease Management Coordinator – Population Health

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⚔️ Virginia, West Virginia – Remote

⚔️ Virginia – Remote ⛰️ West Virginia – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

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WVU Medicine

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

WVU Medicine is a comprehensive health system affiliated with West Virginia University, providing medical services through a network of hospitals across West Virginia. The system includes notable facilities such as J. W. Ruby Memorial Hospital, WVU Medicine Children's, and various other regional medical centers. WVU Medicine offers a wide range of healthcare services, including specialized and advanced medical treatments such as robotic heart surgery. It's also involved in medical education, research, and community health initiatives, emphasizing a mission of delivering high-quality care to the communities it serves.

📋 Description

• Collaborate with patients and primary care providers to ensure quality, efficient, and cost-effective healthcare services • Coordinate, monitor, and evaluate options and services to optimize patients’ health status • Perform ambulatory utilization management, financial management, and quality screening for assigned patients • Identify targeted populations and risk-stratify patients to prioritize needs and direct interventions • Coordinate with inpatient and outpatient case management to implement discharge plans and safe transitions of care • Collaborate with physicians, providers, patients, and families on transitions of care • Design individualized care plans and coordinate healthcare team services • Coordinate social services, financial assistance, entitlement programs, and patient benefits • Facilitate patient progression, transitional planning, advocacy, and education • Use fiscal, clinical, and patient satisfaction data to drive decisions and implement performance improvement strategies • Implement clinical interventions based on risk stratification and evidence-based guidelines • Coordinate laboratory and diagnostic testing and evaluate results, utilization patterns, and quality and efficiency metrics • Participate in development, implementation, evaluation, and revision of clinical pathways and tools • Educate multidisciplinary teams and physicians about clinical pathways, protocols, and managed care principles • Work with leadership to design, implement, and evaluate a centralized care model • Monitor clinical and financial indicators and take action to achieve continuous improvement

🎯 Requirements

• Associate’s Degree in Nursing and seven years of clinical experience in a healthcare setting, or Bachelor’s Degree in Nursing and five years of clinical experience in a healthcare setting • Current Registered Nurse license issued by the state where services will be provided, or current multi-state RN license through the enhanced Nurse Licensure Compact • State criminal background check and federal background check if applicable, as required for regulated areas • Obtain Basic Life Support certification within 30 days of hire • Prior care coordination experience preferred • Excellent interpersonal communication and negotiation skills • Ability to work with people of diverse social, economic, and cultural backgrounds • Flexibility, open-mindedness, and adaptability to change • Ability to exercise independent judgment regarding patients’ psychosocial needs • Ability to work in office and clinical settings • Position focus on D-SNP program; possible occasional travel