Care Coordinator RN
Healthcare Without Rival
Premise Health is proud to partner with Fieldale Farms and is seeking a full-time Care Coordinator RN needed to support our employee health clinic located in Baldwin, GA.
Schedule: Mon - Fri 8am - 5 pm
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 Coordinator 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 members
- 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
- Currently licensed Registered Nurse in state of practice
- Current hands-on certification AHA or ARC Basic Life Support for health care providers; Advanced Cardiac Life Support may also be required based on contract scope of services
- Current Wellness Coach Certification from Wellcoaches® OR equivalent International Coach Federation-accredited program certification (must be obtained within 24 months of hire)
- Bachelor's degree (BSN) from four-year college or university (preferred)
- Multiple state licensure preferred.
- Bilingual Spanish (preferred)
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.
To support Premise Health’s commitment to the safety, health and wellbeing of our team members, clients and patients, Premise Health encourages all new team members to be fully vaccinated and up to date with a COVID-19 vaccine. Where applicable state or local laws or a client require, individuals who are offered and accept a position with Premise Health will be required to provide proof of vaccination in the form of a CDC vaccination card as part of the pre-employment onboarding process. **Except where a reasonable medical or religious accommodation can be granted.