Nurse Care Manager

Nurse Care Manager - Telephonic (local remote)

Tandigm Health, a transformational leader in population health management, is looking for a Nurse Care Manager - Telephonic in the greater Philadelphia area. We offer a competitive compensation and benefits package and are proud to share a culture of diversity and inclusion.

Primary Duties and Responsibilities:

As a Nurse Care Manager with our Complex Care Management Team, you will use your strong organizational and planning skills to design and oversee the delivery of care plans for each patient on your panel. In this telephonic role, you will serve as the primary point of contact for your patients, creating meaningful relationships to maximize the likelihood of patient adherence to the established care plan. You will partner with all members of the Complex Care Management Team by gathering clinical input, facilitating team discussions, and coordinating all elements of the patients' care plans. You will also be the central point-of-contact for your assigned PCPs, maintaining positive relationships between the PCPs and Tandigm Health.

ESSENTIAL FUNCTIONS:

• Consistently exhibits behavior and communication skills that demonstrate Tandigm Health's commitment to superior customer service, including quality, care, and concern for all internal and external customers.
• Serves as primary point of contact for patients and their PCPs.
• Performs initial case management assessments and determines their patients' "current state" by evaluating their physical, psychological, social, environmental, financial, and functional status, as well as the strength of their support system.
• Develops multidisciplinary care plans that address key needs for each patient in their panel; the plans incorporate feedback and results from assessments conducted over the phone by the Nurse Care Manager or other CCM members (e.g., Social Workers and Pharmacy Team).
• Coordinates key logistical activities and elements of each care plan, delegating to CCM members, as appropriate.
• Identifies and monitors the status of high-risk patients.
• Serves as the primary point of contact for patients' medical needs; provides telephonic support, education, monitoring, and assistance to patients and caregivers.
• Consults regularly with Tandigm staff, Tandigm Medical Director, Physician Advisors, and PCPs, as appropriate, to ensure that the care plan remains relevant, appropriate, and responsive to changes in patient status and/or goals.
• Monitors patients' clinical course throughout the care continuum to identify barriers and interventions that support successful transitions.
• Identifies pathways and establishes associated goals and interventions that apply to patients' clinical course to ensure evidence-based care is coordinated.
• Maintains accurate and complete records, documenting pertinent patient information, patient and PCP communications, and all care management activity in the appropriate databases and within the parameters of care management policies and procedures.
• Maintains effective relationships with patients and families, PCPs and office staff, other providers, and community-based agencies.
• Uses, protects, and discloses patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Adheres to and responsible to abide by all information security policies, processes, and/or activities.

Required Qualifications:

EDUCATION:

• Completion of a Bachelor of Science in Nursing (BSN)

EXPERIENCE:

• Minimum 5 years of relevant clinical experience in a hospital, clinical, or home care setting is required
• Minimum 3-5 years of case management (CCM certification preferred), disease management, utilization review (guideline knowledge preferred), and transition of care experience is required

KNOWLEDGE, SKILLS, ABILITIES:

• Ability to analyze and interpret clinical data
• Strong organization and planning skills
• Strong ability to interact and communicate effectively with patients to establish trust and create meaningful relationships to maximize likelihood of patient adherence to the care plan
• Ability to work telephonically and with the addressable population across the member base
• Commitment to act and speak in accordance with Tandigm Health mission and values

LICENSES/CERTIFICATIONS:

• Current and unrestricted Pennsylvania RN license in good standing
• Case Management Certification a plus
• Basic Life Support for Healthcare providers (AHA) or CPR/AED for the Professional Rescuer (American Red Cross)

Applicants must be authorized to work in the US; work visa sponsorship will not be provided.

Equal Employment Opportunities (EEO):

Tandigm provides Equal Employment Opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics.

Search Firm Representatives Please Read Carefully:

Tandigm Health, LLC does not accept unsolicited assistance from search firms for employment opportunities. All CVs/resumes submitted by search firms to any employee at our company without a valid written search agreement in place for this position will be deemed the sole property of our company. No fee will be paid in the event a candidate is hired by our company as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.