Rn Care Manager Wfh

1 week ago

Nashville, United States Work from Home Full time

**Introduction**:
Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family Jump-start your career as an RN Care Manager WFH with HCA Capital Care Coordination today.

**_ **Must be located in the Richmond, VA area to visit practices and attend onsite meetings as required.**_**

**Job Summary and Qualifications**:
The Care Manager supports the patient and primary care relationship through care delivery enhancement. Primary mechanisms for this support are telephonic outreach to patients to guide them through transitions of care, care management, preventive services, and self-management. The Care Manager acts as an integral member of the division Care Coordination team supporting PSG primary care providers and practices in successfully meeting quality improvement initiatives in assigned division(s).

**What you will do in this role**:
General
- Develops professional working relationship with HCA/PSG primary care providers, practice managers, and their staff to collaboratively manage follow-up care and improve overall health and wellness
- Assists in the development of tools, education and workflow processes to assist the division(s) in meeting CMS, ACO, documentation, and payor quality initiatives
- Collaborates with interdisciplinary teams and leaders (PSG, Payer Contracting & Alignment, Quality and Payor Initiatives) to achieve the organization’s coordination of care goals, quality goals, and financial performance goals
- Conducts in-person and virtual meetings with practice managers, staff, providers and managers to communicate program goals, results, and provide education

Care Gaps
- Monitors patient compliance with preventive screening and/or behavioral health management processes using internal and payor reporting tools
- Accesses portals as necessary to prepare reports and other documents to evaluate progress and prioritize workload
- Communicates via telephone and other virtual tools with patients regarding care needs, documenting communications appropriately in the electronic medical record
- Prepares and maintains patient charting as needed and performs medical record reviews for payor projects
- Assists in securing and submitting necessary documentation for annual patient assessment forms (PAFs)
- Understands and addresses short term behavioral health care gaps as needed

Transitions of Care
- Contacts patients after an emergency department encounter or hospital discharge to identify the need for a follow-up appointment, community resource needs, etc.
- Documents assessment in the medical record to support transition of care services as specified by CMS and other program requirements

Care Management
- Triages patients to determine those appropriate for medical and/or behavioral care management
- Creates a care management action plan with the patient/caregiver that includes elements of self-management, as appropriate
- Identifies and enrolls eligible patients in longitudinal or chronic care management for medical or behavioral health conditions
- Oversees the execution of patient care plans in partnership with Care Coordinators
- Facilitates specialty referrals, as appropriate, for conditions/needs managed outside the primary care realm

Population Health
- Assists with practice and provider empanelment processes
- Schedules appointments related to preventive care, chronic disease management, and/or integrated behavioral health
- Prepares and maintains care coordination reports and provides periodic updates to practice leaders and providers

**What Qualifications you will need**:

- Graduate of an accredited college of nursing or social work required
- Knowledge of physician office practice operations and one (1) year of experience in a physician practice is preferred
- Current licensure as an RN in the state of residence and/or practice or current licensure as a Social Worker in state of residence and/or practice
- Must be located in the Richmond, VA area to visit provider practices and attend onsite meetings as required

**Benefits**:
HCA Healthcare offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

- Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
- Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
- Free counseling services and resources for emotional, physical and financial wellbeing
- 401(k) Plan with a 100% match on 3% to 9% of pay (b

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