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Medicare RN Care Coordinator
2 months ago
RN Case Manager for Medicare Patients
Welcome Health, Inc. is a pioneering primary care organization committed to enhancing healthcare for senior citizens. Our care model is rooted in the principles of geriatric medicine. As a risk-bearing entity, we primarily engage with Medicare Advantage plans to improve access and elevate the quality of care for members aged 65 and older who are assigned to us by the health plan or enroll directly. Our services are delivered in three environments: patient residences, clinics/facilities, and through virtual consultations. We are seeking an RN Case Manager to collaborate with our physician-led interdisciplinary teams in managing patients over time and reducing their risk for adverse outcomes such as hospital admissions.
The Case Manager will be tasked with delivering comprehensive case management to Medicare patients, emphasizing effective care coordination to enhance patient outcomes and minimize healthcare expenditures. This role involves close collaboration with patients, their families, and healthcare professionals to ensure optimal management of chronic illnesses, adherence to treatment protocols, and a decrease in hospital readmissions and emergency department visits.
Key Responsibilities:
- Comprehensive Case Management: Engage in the patient care process to assess, plan, facilitate, coordinate, monitor, and evaluate services to meet the health needs of members.
- Care Transition Support: Assist members or their representatives with care transitions and changes in health status. Develop a detailed clinical case management plan for each patient.
- Plan Evaluation and Revision: Gather feedback from providers, patients, and families as necessary, and adjust the care plan accordingly.
- Care Coordination: Oversee and manage extensive care plans for Medicare patients, ensuring continuity across various healthcare settings. Monitor patient outcomes and modify care plans as needed.
- Patient Education: Inform patients and their families about chronic disease management, medication adherence, and self-care strategies. Advocate for preventive health measures and wellness initiatives.
- Treatment Plan Adherence: Track patient compliance with treatment plans and intervene as required to enhance adherence.
- Hospital Readmission Reduction: Implement strategies to minimize hospital readmissions by closely monitoring patient conditions and providing timely interventions.
- Emergency Room Visit Reduction: Create and execute plans to lower unnecessary ER visits through proactive patient management and education.
- Quality Improvement: Participate in initiatives aimed at enhancing patient care and achieving key performance indicators.
- Collaboration: Work in conjunction with primary care providers, specialists, and other healthcare team members to ensure coordinated and efficient care delivery.
- Patient Advocacy: Serve as an advocate for patients, ensuring their needs and preferences are respected and addressed.
- Documentation: Maintain accurate and timely records of patient interactions, care plans, and outcomes in the electronic medical record (EMR) system.
Qualifications:
- A valid RN license in California and other states where Welcome Health operates in the future.
- Bachelor's degree in nursing (BSN) is preferred.
- A minimum of 3 years of clinical nursing experience, with at least 2 years in case management or care coordination.
- Experience in Medicare Advantage health plan case management is strongly preferred.
- Fluency in a second language such as Spanish, Korean, Armenian, or Mandarin Chinese is preferred.
The RN Case Manager is vital to Welcome Health's clinical quality, patient service, and overall success. They will report to the Vice President of Medical Affairs.
Welcome Health is an equal opportunity employer and prohibits discrimination and harassment of any kind.
Benefits include:
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- 401K
- Bonus Potential
- Salary: $105,000 - $135,000 per year
