This position has been filled

Job Overview

Serves   as a member of the care management team of the Grocers Supply Wellness   Clinic. Responsible for assessing, planning, implementing, coordinating,   monitoring and evaluating the treatment options of health care services that   are clinically appropriate in a timely manner.  Assists the Client’s employees in achieving   and maintaining the highest level of individual wellness in order to lower   health care costs and create an overall healthy work environment. Assists in   meeting the patient’s needs by promoting quality and cost effective outcomes.   Follows the core components of the case management process by being able to   coordinate and assure the delivery of service, assess physical as well as   psychological factors involved in planning the patient’s care, evaluation of   the benefits and calculating a cost benefit analysis. Must be knowledgeable   in regards to community resources and apply the case management concepts and   standards of care. Must possess strong skills in communication, empowerment,   facilitation, collaboration, problem solving, as well as being an advocate to   the client. Must be flexible to take on a diversity of tasks and   responsibilities as the role evolves. Works under general supervision with   latitude for initiative and independent judgment. Reports to the Director of Medical   Management.

PRINCIPAL DUTIES   AND RESPONSIBILITIES

 

Performs on-site case   management, disease management and other wellness initiatives.

Develops, implements and   maintains case and disease management care plans for complex and/or large   cases.

Communicates with on-site   physician or patient’s physicians on any inpatient/outpatient stays, services   or procedures.

Communicates, coordinates and   supports 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.

Maintains client and subscriber   confidentiality at all times.

Corresponds by email or phone with   each patient who is willing to work one on one with the nurse on health   management.

Documents thoroughly in the Case   Management database each encounter with a patient.

Follows the plan of care   established with the patients primary care provider, sets goals and action   steps according to the patient’s willingness for change.

Facilitates presentations to   Grocers Supply employees on various topics related to health, wellness and   nutrition. 

Works with members of the Wellness   Center team to develop educational materials and protocols based on   patient/employer needs.

Stays up-to-date on continuing   education, state licensures and certifications.

Performs other duties as   assigned.

QUALIFICATIONS

 

Experience and Education

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

Preferred  

Experience   performing case and disease management.   

Certification   as a Case Manager.

Background   in patient education.

Experience   working with physicians and other ancillary healthcare staff.

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.

Knowledge in properly   interpreting plan documents for utilization review, case management, disease   management and other applicable plan benefits and exclusions.

Knowledge of internal policies   and procedures.

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

Skill in organization.

Skill in interpersonal and   written communication.

Ability to handle a diversity   of tasks and responsibilities.

Ability to demonstrate   leadership skills.

Ability to work independently   and be self-motivated.

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.