Case Management RN Specialist Must Live near Fresno, CA
Posted on: October 12, 2019
Asa part of the Tenet and Catholic Health Initiatives family,
Conifer Healthbrings 30 years of healthcare industry expertise to
clients in more than 135local regions nationwide. We help our
clients strengthen their financial andclinical performance, serve
their communities and succeed at the business ofhealthcare. Conifer
Health helps organizations transition from volume tovalue-based
care, enhance the consumer and patient healthcare experience
andimprove quality, cost and access to healthcare. Are you ready to
be part of oursolutions? Welcome to the company thatgives you the
resources and incentives to redefine healthcare services, with
acompetitive benefits package and leadership to take your career to
the nextstep! JOB SUMMARY The Specialist CaseManager RN, under the
direction of the Supervisor or Manager of Case Managementprovides
direction, identifies health and psychosocial issues of a
selectmember population and assesses, plans, implements,
coordinates monitors andevaluates services and outcomes to ensure
maximized health of the member.Assumes a leadership role within the
interdisciplinary care team to achieveoptimal clinical and resource
outcomes. ESSENTIAL DUTIES ANDRESPONSIBILITIESInclude the
following.Others may be assigned.
- Identifiesissues relating to members' physical and mental
well-being that affects healthstatus and works in collaboration
with both the member and provider todetermine appropriate care for
case management services.
- Incollaboration with the member and PCP completes a
comprehensive assessment anddevelops a care plan assessing
short-term and long-term needs.
- Actsas a leader during interdisciplinary care team conferences
to achieve optimalclinical and resource outcomes.
- Interactscontinuously with member, family, physician(s) and
other providers utilizingclinical knowledge and expertise to
determine medical history and currentstatus. Assess the options for
care including use of benefits and communityresources to update the
- Maintainsand documents initial assessment; designs a care plan
that is attainable and inthe appropriate business application
- Actsas a liaison between physician and member to alleviate
potential issues thatcan interrupt care.
- Maintainscase load by identifying cases that are no longer high
in intensity or servicesand closes them timely and
- Schedulesor facilitates scheduling appointments and follow-up
services; requestsconsultation and diagnostic reports from network
specialists; contacts membersto remind them about upcoming
appointments and/or missed appointments.
- Maintainsand promotes confidentiality of patient information
and adheres to all HIPAAregulations.
- Participatesin monthly case studies in the Medical Services
- Otherduties as assigned.
KNOWLEDGE,SKILLS, ABILITIESToperform this job successfully, an
individual must be able to perform eachessential duty
satisfactorily. The requirements listed below are representativeof
the knowledge, skill and/or ability required. Reasonable
accommodations maybe made to enable individuals with disabilities
to perform the essentialfunctions.
- Experience in CM or other managed care environment.
- Knowledge of disease specific states, clinical and community
- Strong critical thinking and problem solving skills.
- Ability to network, advocate, communicate assertively with all
- Work involving high volume and strict timeframes.
- Excellent communication skills.
- Exceptional organizational skills especially while
multitasking. Ability to drive multiple projects a plus.
- Ability to work in fast paced environment.
- Works well independently as well as part of a team.
- Strong commitment to help others.
- Computer literate; must have experience working with a Medical
Management platform. MS Word, Excel, Outlook a plus EDUCATION
/EXPERIENCEInclude minimumeducation, technical training, and/or
experience preferred to perform the job.
- Minimum Education: LMSW or RN
- Licensure: Licensure must be current and unrestricted in the
- Preferred Education: BA or BS in Nursing, MSW in Social
- Minimum Experience:
- 2+ years of experience in a clinical acute care position,
preferably in home health, physician?s office or public health
- Preferred Experience:
- 1 to 3 years? disease management, case management or formal
patient education experience;
- CCM Certification REQUIREDCERTIFICATIONS/LICENSUREInclude
minimumcertification required to perform the job.
- Licensuremust be current and unrestricted in the appropriate
jurisdiction PHYSICALDEMANDS Thephysical demands described here are
representative of those that must be met byan employee to
successfully perform the essential functions of this job.Reasonable
accommodations may be made to enable individuals with
disabilitiesto perform the essential functions.
- Must be able to work in sitting position, use computer and
- Ability to travel WORK ENVIRONMENT Thework environment
characteristics described here are representative of those
anemployee encounters while performing the essential functions of
this job.Reasonable accommodations may be made to enable
individuals with disabilitiesto perform the essential functions.
- Office Work Environment TRAVEL
- Approximately 5% travel may be required Job: NursingPrimary
Location: Fresno, CaliforniaJob Type: Full-timeShift Type:
Keywords: Tenet, Fresno , Case Management RN Specialist Must Live near Fresno, CA, Healthcare , Fresno, California
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