WVU-Disease Management Coordinator
3 weeks ago
MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Current unencumbered licensure with the WV Board of Registered Professional Nurses, or appropriate state board where services will be provided, as a registered professional nurse OR current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC).
2. Associate’s Degree in Nursing AND Five years clinical experience in a healthcare setting OR Bachelor’s Degree in Nursing AND Three years clinical experience in a healthcare setting.
3. West Virginia state criminal background check required, and Federal, if applicable, for DHHR regulated area.
PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Bachelor’s degree in Nursing (BSN)
EXPERIENCE:
1. Three (3) years of disease management experience.
CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.
1. Ambulatory Utilization Management, Financial Management and Quality Screening for assigned patients.
2. Identifies the targeted population and risk stratifies all patients to prioritize needs and direct interventions.
3. Communicates and collaborates with inpatient and outpatient case management to implement the discharge plan and coordinate a safe transition to the next level of care.
4. Works in collaboration with physicians/providers, patients, and their families to ensure safe and efficient transitions of care.
5. Works collaboratively with patients to design an individualized plan of care that ensures coordination of services by the healthcare team.
6. Collaborates with available social services for appropriate resource and financial management which may include, but is not limited to financial assistance coordination/referrals, entitlement program coordination/referrals, patient benefit coordination, assessment for appropriate usage of Health Care Resources/clinical cost efficiency.
7. Coordinates/facilitates patient progression throughout the continuum, Transitional Planning, Advocacy and Education:
8. Clinical performance improvement, outcome management and quality activities.
9. Uses data to drive decisions and plan/implement performance improvement strategies for assigned patients, including fiscal, clinical and patient satisfaction data
10. Implements clinical interventions based on risk stratification and evidence-based clinical guideline adherence and promotes best practice by initiating/adjusting therapies as directed by the practitioner and providing appropriate follow-up monitoring as needed.
11. Coordinates appropriate laboratory and diagnostic testing.
12. Continuously evaluates laboratory results, diagnostic tests, utilization patterns and other metrics to monitor quality and efficiency results for assigned population
13. Participates in development, implementation, evaluation and revision of clinical pathways and other tools.
14. Educates the multidisciplinary team and physicians about clinical pathways/protocols and managed care principles
15. Works with leadership to design, implement, and evaluate a centralized care model that optimizes value. Works with leadership to continuously evaluate process, identify problems, and propose process improvement strategies
16. Monitors clinical and financial indicators on an ongoing basis and takes action to achieve continuous improvement in both areas.
PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. The National Institute for Occupational Safety and Health recommends minimizing the need for employees to manually lift patients, and limit safe patient handling to 35 pounds. All transfers, lifts and re-positioning will be completed utilizing the lift equipment and/or other patient handling aids as indicated by the patient’s profile and appropriate algorithms.
2. Heavy/Hard work: Work requires strength and/or stamina, lifting, moving, stooping, reaching, standing, walking, and carrying of materials and equipment weighing 35+lbs
WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Working closely with others.
2. Working protracted or irregular hours.
3. Working around biohazards.
4. Working around infectious diseases.
5. Working with or near the deceased.
6. Working with hands in water.
7. Working with electrical hazards associated with patient care equipment.
SKILLS AND ABILITIES:
1. Knowledge of and appropriate application of the nursing process.
2. Knowledge of professional theory, practice and procedure.
3. Ability to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership and other.
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