Nurse Care Manager

6 days ago


Baton Rouge, United States Louisiana Primary Care Association Full time $31,900 - $59,200
Louisiana Primary Care Association

Position Description
Position Title: Nurse Care ManagerFull-time ExemptSupervisor: Director of Managed Care and Network Development
Position Summary: The Nurse Care Manager is responsible for developing patient care plans while providing patient education, guidance, and support, as well as maintaining a comprehensive care plan.
Responsibilities:
  • Help close AWV gaps.
  • Utilize patient information with the goal of achieving 4-star level performance in each medication adherence measure.
  • Use nursing assessment skills to help guide care decisions while working collaboratively with an interdisciplinary care team to provide supportive care to patients. 
  • Outreach to patients to schedule annual wellness visits.
  • Ensure that medical services are managed effectively and that the plan of care addresses the clinical condition and psychosocial needs of patients to maximize the goals of care. 
  • Monitor patient progress against plan of care goals with an emphasis on patient care needs during transitions and health changes. 
  • Manage transitions of care and other care management services.
  • Support contracted provider care management team on the use of payer analytics and reporting and incorporate contracted provider’s internal analytical tools into pre-visit planning to improve gap closure at AWVs. 
  • Work directly with contracted providers and attributed members to removing barriers to filling medications appropriately. 
  • Work on other HEDIS campaigns in coordination with the contracted provider’s care management team.
  • Work closely with the Health Plan Quality Practice Advisor in the coordination of activities to meet STAR goals.
  • Provide feedback to providers on risk-adjustment and quality coding opportunities, in coordination with contracted provider coders.

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