Case Manager
3 weeks ago
Premise Health is the world's leading direct healthcare provider and one of the largest digital providers in the country, serving over 11 million eligible lives across more than 2,500 of the largest commercial and municipal employers in the U.S. Premise partners with its clients to offer fully connected care – in-person and in the digital environment. It operates more than 800 onsite and nearsite wellness centers in 45 states and Guam, delivering care through the Digital Wellness Center and onsite, nearsite, mobile, and event solutions. Premise delivers value by simplifying complexity and breaking down barriers to give diverse member populations access to convenient, integrated, high-quality care. We offer more than 30 products, delivering the breadth and depth of care required to serve organizations' total populations. The result is healthcare that meets the needs of members and their families, helping them live healthier while lowering costs for organizations. Premise offers a wide range of dynamic, purpose-driven career opportunities. We are currently looking for a full time Field Care Manager RN to join our team in Sunnyvale, CA. This position starts in October 2024. PURPOSE OF THE POSITION RN position that leverages powerful data insights to proactively identify and engage members who need support the most. Nurses will design individualized care plans, offer self-management education and coordination of resources that assists members to achieve improved health. Collaborates closely with clinical teams to provide guidance on engagement strategies, focused on improving health status of members. Manages a panel of high-risk members with chronic conditions to provide frequent touchpoints and ensure care gap closure as defined by national standards. Facilitates Care Team meetings to ensure an interdisciplinary approach to care for member panel. ESSENTIAL JOB FUNCTIONS
- Develops personalized treatment plans using provider care plans and member preferences using a coach approach and the pillars of Lifestyle Medicine
- Supports a proactive, multidisciplinary team approach directed toward prevention, education and health promotion
- Establishes supportive relationship with members
- Assesses member’s educational/clinical/social needs, prioritizing care based on elicited information from the member, Epic, and data analysis
- Acts as resource for members
- Documents touchpoints and progress into the electronic medical record
- Collaborates with the full scope of clinical team members to arrange for further medical treatment when needed
- Provides support and tools needed to help members take control of their health
- Delivers exceptional member experiences and engaging members in their healthcare journeys
- Improves health outcomes and better management of any chronic condition
- Lowers healthcare costs while improving outcomes
- Consults with other members of the healthcare team to solve problems and seek advice
- Works closely with client’s vendors as appropriate to support member’s needs where appropriate
- Identifies emergency situations and provides care within legal scope of practice
- Maintains member privacy and confidential member information
- Participates in outreach/follow-up phone calls and follow-up member visits
- Provides condition specific self-care education to client employee enrolled in the various condition management programs
- Serves as member advocate
- Acts as facilitator of Care Team meetings.
- For clients with CC+, proactive outreach to high-risk members identified through claims data
- Coaches effectively virtually using video and phone
- Collaborates with health center staff to coordinate and promote health and wellness programs
- May require other duties as assigned.
- Currently licensed Registered Nurse in state of practice
- Current certification AHA or ARC Basic Life Support for health care providers
- Current Wellness Coach Certification from Wellcoaches® OR equivalent International Coach
- Federation-accredited program certification (must be obtained within 24 months of hire)
- Bachelor's degree (BSN) from four-year college or university (preferred)
- At least three years’ experience as a Registered Nurse caring for members with any of the following conditions: Type 2 diabetes, asthma, heart disease, heart failure or hypertension.
- Experience in Condition Management, Certificate in Case Management, Care Coordination, Certified Diabetes Educator (CDE) Certified Diabetes Care and Education Specialist (CDCES) a plus
- Knowledge of internet software, spreadsheet software and Word Processing software
- Knowledge and experience with Electronic Medical Records (preferred)
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