Chronic Condition Care Coordinator RN

6 days ago

Independence, Iowa, United States Hines & Associates Inc Full time

About Hines & Associates Inc.

We are a nationwide, independent leader in personalized managed health care, focused on delivering comprehensive services with program excellence and cost containment. Our reputation as an industry leader is founded on over three decades of innovative and professional health care excellence.

What We Offer

  • A competitive salary of $95,000 per year, along with benefits including medical, dental, vision, long-term care, short-term disability, long-term disability, and company-paid life insurance.
  • A 401(k) plan with a company match, fully vested after one year.
  • Paid holidays and time off.
  • Work-life balance.
  • No weekends or holidays.
  • A hybrid setting, allowing for up to two days per week of remote work.

Job Description

As a Chronic Condition Care Coordinator RN, you will utilize your clinical nursing experience to develop a plan for meeting the healthcare needs of our patients, while continuing to professionally grow in healthcare knowledge and perspective. You will be responsible for utilizing medical knowledge to assess patient needs and provide individualized coaching for developing a plan to meet their healthcare needs and goals of self-management of chronic medical conditions.

Duties and Responsibilities

  • You will identify problems while assessing the patient's medical and psychosocial status, including environmental and cultural influences.
  • You will determine economically responsible options available to meet the patient's medical and care needs.
  • You will understand policy/benefit plans and systems.
  • You will collaborate with physicians, providers, and patients/families and payers to facilitate quality, timely, and efficient medical care across the healthcare continuum.
  • You will implement disease management plans by coordinating resources, including community resources, healthcare providers, and significant others.
  • You will evaluate the disease management plan and its effects on the patient, making modifications as necessary.
  • You will improve health outcomes and quality of life with reduced complications and costs for persons with chronic health conditions.
  • You will promote patient self-management of chronic health conditions through individual assessment, education, and use of motivational interviewing principles/techniques.
  • You will utilize clinical practice guidelines and promote best care for people with chronic medical conditions.
  • You will demonstrate ability to communicate effectively with TPAs, insurers, physicians, patients/families, and other healthcare providers, including ability to negotiate with assertiveness.
  • You will effectively communicate the disease case manager's impressions of methods available to provide for the medical needs of the individual patient or the need to refer to a higher level for review of questionable plans of treatment.
  • You will provide written documentation concerning the information obtained regarding the patient's status, treatment plan, and disease management interventions.
  • You will interface with UM, CM, and peer review, and other programs, as indicated on active cases.
  • You will communicate knowledge of policy and procedure, standards of practice, and their revision; participate in annual HIPAA, ethics, cultural, and URAC standards training.
  • You will provide good customer relations by promoting goodwill and understanding between claimants, payers, providers, and professional staff at all times.
  • You will act as an advocate, maintain privacy, confidentiality, promote safety, and be compliant with policies and procedures, URAC standards, and other regulatory standards.
  • You will be responsible for and retain accountability for the disease management plan and process when using assistance of support staff; provide input on the support staff to their supervisor.
  • You will participate in special projects assigned by your supervisor.

Requirements

Qualifications

  • You must be a registered nurse with a current unrestricted license to practice in the state or in a state that has licensure reciprocation with the state of the office location where you will be working.
  • You must have successfully completed a disease management orientation program.
  • You must have a minimum of two years of full-time equivalent direct clinical care to the consumer.
  • You must have excellent communication skills.
  • You must have basic typing/computer knowledge with a minimum keyboarding speed of 35 WPM.
  • Previous disease management or case management experience is helpful but not required.
  • Obtaining certification in CCM or CHC is encouraged.

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