Case Manager-Disease Management/Hedis Outreach - BLU00069
DESCRIPTION/RESPONSIBILITIES:
Responsible for utilizing the nursing process in the development of treatment plans, with established goals, implementation, monitoring and evaluation of an assigned patient caseloads in order to provide quality care appropriate to clinical needs.
Review and analyze referrals from a variety of sources for acceptance into the program. Evaluate patient needs, identify and recommend cost-effective health care options. Assure member health needs are consistent with nursing standards and practices, provide recommendations. Develop and monitor action plans established between member, family and/or designee and physician. Make arrangements for DME supplies, medications, community resources and facilities. Educate patient and family and/or designee to processes, care practices, medication(s) and benefits. Review patient status, educate patient on self-management and ensure appropriate levels of post care education are provided. Identify potential gaps in member discharge to be avoided through education, empowerment and/or motivational interviewing. Internal peer review for quality performance. Continues professional development by attending relevant educational programs at lease annually.
All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, protected veteran status or status as an individual with a disability.
VEVRAA Federal Contractor
Request Priority Protected Veteran Referrals
EOE -Veteran /Disabled/Minority/AA/F/M/SO
