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POPULATION HEALTH MANAGEMENT RN Job in Canton, Ohio US

POPULATION HEALTH MANAGEMENT RN

Aultcare Corp. - Canton, OH

Posted: 9/27/2021 - Expires: 12/26/2021

Job ID: 232145285

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Job Description

Req# 19587

Aultman Health Foundation, CANTON, OH

AULTCARE ADMINISTRATION

Aultman Health Foundation

Part Time / Full Time, Day Shift, As Scheduled





PURPOSE OF POSITION:

The primary purpose of the RN Care Coordinator is to provide enrollee-centered care in order to educate, advocate for, and empower the enrollee by coordinating resources and facilitating communication within the healthcare delivery system. The RN Care Coordinator works collaboratively with other disciplines including physicians, pharmacist and employers to provide care coordination across the healthcare continuum for all AultCare and PrimeTime Health Plan members.  The Care Coordinator must provide efficient, quality service at all times while advocating for members.

RESPONSIBILITIES & EXPECTATIONS:

 


Maintain a basic understanding of important industry standards set forth by organizations such as NCQA, CMS, ODI, etc.
Develop strong working relationships with internal departments (Utilization Management, Pharmacy, Disease/Case Management, Data and Reporting, Claims, Customer Service, etc.)
Deals with people in a broad range of circumstances discussing treatments, costs, equipment, physician and/or employer group client specific financial and utilization metrics.
Proactively acts as a patient advocate, responding with empathy and respect to resolve the member's concerns.
Provides coordination of care across the care continuum by acting as a liaison for member's with physicians, office staff, facilities and community resources.
Supports the member's autonomy promoting health, disease prevention and chronic condition management.
Must understand complex clinical data and have the ability to present that data in a variety of settings.
Anticipate and follow through with both internal and external customer requests to their satisfaction.  Seek assistance of others and other departments when needed.
Maintain cooperative approach in dealing with co-workers, creating productive working relationships with physicians and employer groups.
Communicate with internal and external customers in professional manner and maintain positive interaction with other medical professionals, discussion treatments, costs, equipment, discharge planning and individual treatment plans
Process Improvement: Continuously reviews, recommends and implements improvement steps, as needed or directed.
Seeks supervisory guidance/approval as appropriate.
Portrays professional image: follows dress code; communicates with internal and external customers in a professional manner, including appropriate verbal and written grammar.
Maintain confidentiality or enrollee and employer information at all times.
Comply with policies, procedures and code of conduct, Ohio Nurse Practice Act, National Association of Social Workers Code of Ethics, Case Management Society of America Standards, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other governing and accrediting bodies
Utilize the CMSA Standards of Practice for Case Management to assess needs, establish realistic goals, and facilitate an appropriate plan in concert with member/family, facility, and other health care professionals while promoting a cost-effective use of resources.
Promotes and demonstrates professional standards to enhance the development of the department
Practices ethical conduct.
Meets acceptable attendance and punctuality expectations (excluding FMLA.
 
The above statements reflect the general duties considered necessary to describe the principle functions of the job as identified, and shall not be considered as a detailed description of all the work requirements that may be inherent to this position.
 
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, disability, gender identity, sexual orientation, or protected veteran status.  AultCare is an EEO/AA Employer M/F/Disability/Vet.

AultCare/AHF will provide reasonable accommodations to employees or applicants with disabilities, as defined by the Americans with Disabilities Act, who are otherwise qualified to safely perform the essential functions of the job, with or without accommodation, unless such accommodation would constitute an undue hardship on AultCare/AHF or poses a direct threat to the health and safety of the individual or others that cannot be sufficiently mitigated by reasonable accommodation. Any applicant or employee who requires an accommodation to perform the essential functions of his or her job or to enjoy equal benefits and privileges of employment should notify the AultCare Human Resource Department and request such an accommodation. 


QUALIFICATIONS:
Education:  Graduate of an approved School of Nursing with a minimum of 4-5 years' experience.  Type and setting of clinical experience will be considered in lieu of the minimum 4-5 years' experience.
Maintains current unrestricted RN licensure, active CPR certification
Demonstrates willingness to become certified in Case Management or another appropriate professional specialty. 
Excellent verbal and written communication skills.
Experience with Microsoft Office, including Word, Excel, Outlook and Power Point.
Able to cope with mental and emotional stressors of the position and deadlines.
Functions independently with flexibility, integrity, and the ability to work effectively and efficiently with all levels of personnel.
Possesses good interpersonal communication skills and works well with a diversity of co-workers.
Displays professional manner and appearance, complying with the corporate dress code.
 
WORKING CONDITIONS:
Hours of operation are 7:00 AM to 5:00 PM, Monday through Friday, of which an eight-hour shift is assigned.  Occasional adjustment of work hours may be necessary to meet deadlines and implement employer based onsite wellness programs and or physician meetings. 
Some travel may be required for which you will be required to use your own automobile with mileage reimbursement as applicable
Work in physician office or company's designated office space
Sitting/standing/moving about intermittently during working hours.
Subject to frequent interruptions and changes in priority of duties throughout the day.

AultCare is an Equal Opportunity Employer (EOE) that values and respects the importance of a diverse and inclusive workforce.  It is the policy of the company to recruit, hire, train and promote persons in all job titles without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, protected veteran status or disability.  We recognize that diversity and inclusion is a driving force in the success of our company.  AultCare is an Equal Opportunity Employer that will make reasonable accommodation to enable individuals with disabilities to apply and compete for employment opportunities for which they are qualified.  To request an accommodation, please email our Human Resources department at kbricker@aultcare.com , or call 330-363-6388, for further assistance.

Job Summary

Employment Type:
Per Diem Employee
Job type:
Federal Contractor
Skill Based Partner:
No
Education Level:
No school grade completed
Work Days:
Mon, Tue, Wed, Thu, Fri
Job Reference Code
59975832
Salary
N/A
Licenses / Certifications:
N/A
Display Recommended WorkKeys®Recommended WorkKeys®:
N/A