POSITION PURPOSE: (The major reason why this job exits; its primary mission or accountability)
Responsible for the care management and coordination of all high-risk high need patients assigned to a specific site, including both in and out patient clinical care. Assists clinicians in making informed decisions with these patients in order to promote better outcomes and smooth transitions of care. Follows the standards of Case Management and acts as the single point of contact for patients, families, and providers. Maintains records and data analysis related to high risk cases to report outcomes and ROI. Works collaboratively with all internal and external partners to ensure better clinical outcomes.
Responsibilities: (In order of importance, describe 4-8 primary duties including what is done and why. This is not a list of every activity performed. It is a summary of the most important tasks and their expected results)
1. Apply case management standards of practice to focus on effective care of high risk high need patients at a specific site
2. Serve as a patient advocate and resource and provide critical information and recommendations to the rest of the care team.
3. Participates in assessment activities to develop individualized plans of care in coordination with patient, family and providers
4. Follows patient through various transitions of care to ensure that any gaps are identified and remedied, break down silos and promote efficient health care delivery.
5. Maintains strong knowledge of UM, Case management, community resources and plan benefits to ensure improved outcomes
6. Works collaboratively with primary care on site staff to ensure patient compliance and adherence to medical plan of care.
7. Assist clinicians in implementing best practices for chronic care and disease management
8. Follow standard protocols, processes and policies to include but not limited to the following: Medication Refill, Preventative Services, Managing Conditions, and Disease Case Management as signed by department head or designee
QUALIFICATIONS (Identify the knowledge, skills and experience minimally required to do the job)
Knowledge: Demonstrated ability to perform case management activities. Strong clinical knowledge and capacity for continued learning. Knowledge of UM and plan benefit designs
Skills: Strong verbal and written communication skills. Competent with MS Office and other practice management systems or possess the ability to continue to learn new things.
Experience: Minimum three to five years direct patient care nursing with a focus on discharge planning or case management. CCM certification preferred.
Critical Proficient in critical thinking skills of RN Case manager. Ability to organize and prioritize tasks for self and patients.
EDUCATION, LICENSES & CERTIFICATION REQUIRED (Indicate whether required or preferred) High School diploma or equivalent required. Registered Nurse with active unrestricted license in the State of Nevada required. Bachelor s degree in healthcare or related field preferred or working towards completion of Bachelor s degree. CCM certification preferred.
Must possess a valid Nevada driver s license and maintain personal auto insurance coverage.
WORKING CONDITIONS (i.e. exposure to hazardous materials, heavy lifting, normal office environment, etc.) Normal clinic environment. Ability to have their own transportation to travel frequently within the Las Vegas Valley. Ability to pass FIT testing and wear protective mask as deemed by SMA in the course of work at clinic.
Hours are M-F; 8:00am 5:00pm
At Maxim Healthcare Services, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits:
Competitive pay & weekly paychecks
Health, dental, vision, and life insurance
401(k) savings plan
Awards and recognition programs
*Benefit eligibility is dependent on employment status.
Maxim Healthcare Services is a leading provider of home healthcare, medical-related staffing, travel nursing, and population health and wellness services across the United States. As an established community partner, we have been making a difference in the lives of our employees, caregivers, and patients for more than 30 years. Our commitment to customer service, improving patient care, and staffing experienced healthcare professionals has paved the way for many rewarding career opportunities in the healthcare industry.
Maxim Healthcare Services, Inc. is an Affirmative Action/Equal Opportunity Employer
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.