Job Overview

Implements strategies to   achieve and ensure patient follow-up according to clinical strategic   measures/outcomes. Coordinates, educates and counsels patients and families   regarding preventative care, medical problems and the use of various   treatments for specific medical conditions. Responsible for managing   patient’s health status across the continuum of care. Works under general   supervision with latitude for initiative and independent judgment. Reports to   the director of Prime Dx.

PRINCIPAL DUTIES   AND RESPONSIBILITIES

 

Performs on-site and telephonic   disease management assessments and follow-up interventions.

Communicates and coordinates   on-going health care services with physicians.

Implements strategies to ensure   patient follow-up.

Develops patient/family   educational plans to promote self-management.

Coordinates ongoing educational   needs of patients and their families as related to their disease and   self-management.

Assists the patient/family with   integrating the implications of the illness recovery and health promotion   into their lifestyle.

Instructs and counsels   patients/families regarding the disease and its relation to preventive care,   medical problems, psychological problems and the use of various treatments.

Interprets plan documents for   utilization review, case management, disease management and healthcare elements.

Travels up to 30% of the time to   Houston, Victoria, Austin and surrounding areas.

Maintains client and subscriber   confidentiality at all times.

Performs other duties as   assigned.

QUALIFICATIONS

 

Experience and Education

Bachelor’s   degree and current RN license in the State of Texas is required.  At least five years of medical/ surgical/   hospital experience is essential.

Preferred  

Experience   performing case and disease management.   

Certification   as a Case Manager.

Background   in patient education.

Knowledge, Skills, and Abilities

Knowledge of business   correspondence, filing and general office procedures.

Knowledge of current healthcare   protocols.

Knowledge of ICD-9 and/or CPT-4   codes.

Skill with standard office   operating equipment and various Microsoft Office applications.

Skill in organization.

Skill in interpersonal and   written communication.

Ability to accurately compile   data and perform detailed work.

Ability to meet deadlines.

Ability to maintain regular   attendance.

Ability to maintain confidentiality of material and   information.

Ability to maintain professional appearance and demeanor.

Ability to work as a member of a team.