Per Diem Nurse

5 days ago

New York, New York, United States VNS Health Full time
About the Role

VNS Health is seeking a skilled and compassionate Per Diem Nurse to join our team. As a Per Diem Nurse, you will play a critical role in providing high-quality, patient-centered care to our members.

Key Responsibilities
  • Telephonic Clinical Care Management: Provide telephonic clinical care management services using evidence-based practices to ensure effective utilization of benefits, services, and care is provided to our members.
  • Care Coordination: Coordinate and/or oversee the coordination of benefits and services for all members on your caseload.
  • Assessment and Intervention: Complete care management and disease-specific assessments, and make timely telephonic care management calls based on risk level.
  • Complex Issue Resolution: Resolve and coordinate complex issues and member complaints impacting the delivery of services.
  • Health Education: Provide health education to members and caregivers.
  • Social Determinants of Health: Assess social determinants of health and provide care coordination to reduce/remove barriers to care.
  • Member Safety: Identify member safety issues and intervene as necessary or refer to appropriate resources.
  • Quality and Cost-Effective Care: Coordinate the delivery of high-quality, cost-effective care based on a customized population model of care supported by evidence-based clinical practice guidelines.
  • Advocacy: Advocate for members and caregivers to obtain the healthcare and other services needed to optimize their quality of life.
  • Transition Planning: Utilize the Care Management process to set priorities, plan, organize, and implement interventions that are goal-directed towards self-care outcomes and the transition to independent status.
  • Pharmacotherapy: Promote adherence to the physician treatment plan by providing education, coaching, and support.
  • Utilization Management: Educate, coordinate, and provide resources to reduce inappropriate utilization of emergency room (ER) and hospital services.
  • Interdisciplinary Team Collaboration: Participate in interdisciplinary team (IDT) meetings and provide input on customer service-related activities.
  • Confidentiality and Compliance: Protect the confidentiality of member information and adhere to company policies regarding confidentiality, as well as ensure compliance with payors' policies and procedures and all Federal and State regulations.
Requirements
  • Licenses and Certifications: License and current registration to practice as a Registered Professional Nurse in NYS required.
  • Certifications: Certified Case Manager - Commission for Case Manager Certification within 1 year of employment required.
  • Education: Associate's Degree in nursing required.
  • Work Experience: Minimum two years of experience in a health-related field required.

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