Condition Management RN

Case Manager Jobs Springfield, Missouri


Description

Healthcare Without Rival

Premise Health is the world's leading direct healthcare provider and one of the largest digital providers in the country, serving over 11 million eligible lives across more than 2,500 of the largest commercial and municipal employers in the U.S. Premise partners with its clients to offer fully connected care – in-person and in the digital environment. It operates more than 800 onsite and nearsite wellness centers in 45 states and Guam, delivering care through the Digital Wellness Center and onsite, nearsite, mobile, and event solutions.

Premise delivers value by simplifying complexity and breaking down barriers to give diverse member populations access to convenient, integrated, high-quality care. We offer more than 30 products, delivering the breadth and depth of care required to serve organizations' total populations. The result is healthcare that meets the needs of members and their families, helping them live healthier while lowering costs for organizations.

Premise offers a wide range of dynamic, purpose-driven career opportunities, and we are proud to partner with Bass Pro Shops and are currently looking for a Part-Time Care Manager Registered Nurse (RN) to join our new employer based health center, in Springfield, MO.

PURPOSE OF THE POSITION

RN position that leverages powerful data insights to proactively identify and engage members who need support the most. Supports members through scheduled visits and outreach, providing care, education and coordination of resources that assists members to achieve improved health. Collaborates closely with clinical teams to provide guidance on engagement strategies, focused on improving health status of the members. Manages a panel of high-risk members with chronic conditions to provide frequent touchpoints and ensure care gap closure as defined by national standards. Facilitates Care Team meetings to ensure an interdisciplinary approach to care for member panel.

ESSENTIAL JOB FUNCTIONS

  • Care Manager RN responsibilities:
  • Proactive outreach to high risk members identified through claims data
  • Develop personalized treatment plans using provider care plans and member preferences
  • Supports “Individual contributor to” a proactive, multidisciplinary team approach directed toward prevention, education and health promotion
  • Establishes supportive relationship with member.
  • Assesses member’s educational/clinical/social needs, prioritizing care based on elicited information from the member, Epic, and data analysis
  • Acts as resource for members
  • Documents touchpoints and progress into the electronic medical record
  • Collaborates with the full scope of clinical team members to arrange for further medical treatment when needed
  • Provide support and tools needed to help members take control of their health
  • Delivering exceptional member experiences and engaging members in their healthcare journeys
  • Improving health outcomes and better management of any chronic condition
  • Lowering healthcare costs while improving outcomes
  • Consults with other members of the healthcare team to solve problems and seek advice
  • Works closely with client’s vendors as appropriate to support member’s needs
  • Identifies emergency situations and provides care within legal scope of practice
  • Maintains member privacy and confidential member information
  • Participates in outreach/follow-up phone calls and follow-up member visits
  • Assists in the development of criteria to measure outcomes, assists in the analysis of data for quality improvement, interprets study results, identifies limitations and barriers and recommends alternatives
  • Provides condition specific self-care education to client employee enrolled in the various condition management programs
  • Serves as member advocate
  • Acts as facilitator of Care Team meetings.
  • May require other duties as assigned.
  • Additional skills that may be required:
  • Designs interventions with the member to improve outcomes
  • Coach effectively using in-person, video and telephonic platform
  • Collaborates with health center staff to coordinate and promote health and wellness programs
  • May assist Operations in assessing and maintaining reports, evaluating clinical program(s) & conducting ongoing evaluation of the effectiveness of the programs
  • Develops and presents educational services for associated persons or departments as appropriate
  • Comfortable with using Excel

BASIC QUALIFICATIONS

Education:

  • Currently licensed Registered Nurse in state of practice
  • Current certification AHA or ARC Basic Life Support for health care providers
  • Bachelor's degree (BSN) from four-year college or university (preferred)

Experience:

  • At least three years’ experience as a Registered Nurse caring for members with any of the following conditions: Type 2 diabetes, asthma, heart disease, heart failure or hypertension.
  • Experience in Condition Management, Certificate in Case Management, Care Coordination, Certified Diabetes Educator (CDE) Certified Diabetes Care and Education Specialist (CDCES) a plus
  • Certified in an ICF-accredited coaching program (preferred)
  • Understanding of data analysis in a healthcare environment
  • Knowledge and experience with Electronic Medical Records (preferred)
  • Multiple state licensure preferred.

Knowledge and Skills:

  • Knowledge of internet software, spreadsheet software and Word Processing software


Work-life balance is at the foundation of how decisions are made and where Premise is headed. We can only help people get, stay, and be well if we do the same for ourselves. In addition to competitive pay, Premise offers benefits packages including medical, dental, vision, life insurance, 401(k), paid holidays and vacation time, a company-sponsored wellness program, and much more our talent acquisition team will be happy to share with you.

Premise Health is an equal opportunity employer; we value inclusion, and we do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status or disability status.

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