Chronic Care Improvement Coordinator (189009-955)

Description



Responsible for increasing patient compliance through education to optimize health and minimize complications and exacerbation

Responsibilities: Identify at risk members for possible case management intervention. Interface with providers to facilitate effective communication, referrals, and alternative treatment plans. Initiate contact with patient, family, physician, health care providers and suppliers to coordinate services. Assess and evaluate each member in the program Collaborate with the attending physician to achieve identified patient outcomes Develop, coordinate and implement Chronic Care Improvement Plan Continuously monitor, reassess and reevaluate that the treatment plan remains appropriate. Evaluate each case for quality of care; document quality issues and appropriately refer questionable outcomes to quality management staff. Communicate with all departments to resolve issues or document trends Attend and actively participate in weekly staff meetings Understand and follow Health Services established policies and procedures. Oversee the operation of delegated entities regarding members in the program to include coordination and service delivery, and cost analysis if applicable. Collect detailed information from the delegated entity monthly as needed, if applicable. May perform home visits when necessary Other duties as assigned. Required Skills

Verbal and written communication skills Interpersonal skills Basic mathematical and statistical ability Organization skills Basic computer knowledge Knowledge of utilization review requirements and procedures Knowledge of current health care practices and appropriate treatments Knowledge of community resources Required Experience



Experience:  Current licensure as a registered nurse in the state of Tennessee Bachelors degree preferred Five (5) years recent experience in an acute care environment, or Two (2) years recent experience in case management or utilization management Prefer Certified Case Manager