Disease Mgmt Coord-Cheat Lake Hybrid

WVU Medicine; Cheat Lake (WV); Vor Ort; USD 65.000 - 90.000; Vollzeit

Zusammenfassung

West Virginia University Health System is seeking a Disease Management Coordinator to collaborate with patients and primary care providers to optimize health status. The role focuses on ambulatory management, risk stratification, care transitions, and coordinating services across the healthcare team.

The position requires an RN license with appropriate experience, strong communication, and a commitment to improving clinical and financial outcomes.

Qualifikationen

• Associate’s Degree in Nursing with 7 years of clinical experience, or a BSN with 5 years clinical experience.
• Current RN license in the state or multi-state licensure via eNLC.
• State and Federal background checks as required.
• Basic Life Support certification within 30 days of hire.

Aufgaben

• Ambulatory Utilization Management, Financial Management and Quality Screening for assigned patients.
• Identify population and risk stratify patients to prioritize needs and interventions.
• Coordinate discharge planning with inpatient and outpatient case management.
• Collaborate with physicians, patients and families to ensure safe transitions of care.
• Design individualized plans of care to coordinate services by the healthcare team.
• Coordinate with social services for financial assistance and resource management.
• Facilitate patient progression across continuum and transitional planning.
• Engage in clinical performance improvement and quality activities.
• Use data to drive decisions and plan improvements for fiscal, clinical and patient satisfaction metrics.
• Implement interventions based on risk stratification and evidence-based guidelines.
• Coordinate laboratory and diagnostic testing as needed.
• Evaluate lab results and utilization to monitor quality and efficiency.
• Contribute to development and revision of clinical pathways and tools.
• Educate the multidisciplinary team on pathways and managed care principles.
• Work with leadership to design centralized care models and drive process improvements.
• Monitor clinical and financial indicators and take action for continuous improvement.

Kenntnisse

Interpersonal communication

Negotiation

Adaptability

Independent judgment

Ausbildung

Associate’s Degree in Nursing

Bachelor’s Degree in Nursing

Jobbeschreibung

The Disease Management Coordinator collaborates with patients and primary care providers to ensure patients receive quality, efficient, and cost-effective healthcare services. Coordinates, monitors, and evaluates all options and services to optimize a patient’s health status.

MINIMUM QUALIFICATIONS : :

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Associate’s Degree in Nursing AND Seven(7)yearsclinical experience in a healthcare setting OR Bachelor’s Degree in Nursing AND Five (5) years clinical experience in a healthcare setting.

2. Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC).

3. State criminal background check and Federal (if applicable), as required for regulated areas.

4. Obtain certification in Basic Life Support within 30 days of hire date.

PREFERRED QUALIFICATIONS : :

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1.Bachelor’s Degree in Nursing.

EXPERIENCE:

1. Prior care coordination experience.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.They are not intended to be constructed as an all-inclusive list of all responsibilities and duties.Other duties may be assigned.

1. Ambulatory Utilization Management, Financial Management and Quality Screening for assigned patients.

2. Identifies the targeted population and risk stratifies all patients to prioritize needs and direct interventions.

3. Communicates and collaborates with inpatient and outpatient case management to implement the discharge plan and coordinate a safe transition to the next level of care.

4. Works in collaboration with physicians/providers, patients, and their families to ensure safe and efficient transitions of care.

5. Works collaboratively with patients to design an individualized plan of care that ensures coordination of services by the healthcare team.

6. Collaborates with available social services for appropriate resource and financial management which may include, but is not limited to financial assistance coordination/referrals, entitlement program coordination/referrals, patient benefit coordination, assessment for appropriate usage of Health Care Resources/clinical cost efficiency.

7. Coordinates/facilitates patient progression throughout the continuum, Transitional Planning,Advocacy and Education:

8. Clinical performance improvement, outcome management and quality activities.

9. Uses data to drive decisions and plan/implement performance improvement strategies for assigned patients, including fiscal, clinical and patient satisfaction data

10. Implements clinical interventions based on risk stratification and evidence-based clinical guideline adherence and promotes best practice by initiating/adjusting therapies as directed by the practitioner and providing appropriate follow-up monitoring as needed.

11. Coordinates appropriate laboratory and diagnostic testing.

12. Continuously evaluates laboratory results, diagnostic tests, utilization patterns and other metrics to monitor quality and efficiency results for assigned population

13. Participates in development, implementation, evaluation and revision of clinical pathways and other tools.

14. Educates the multidisciplinary team and physicians about clinical pathways/protocols and managed care principles

15. Works with leadership to design, implement, and evaluate a centralized care model that optimizes value.Works with leadership to continuously evaluate process, identify problems, and propose process improvement strategies

16. Monitors clinical and financial indicators on an ongoing basis and takes action to achieve continuous improvement in both areas.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Office and clinical settings

SKILLS AND ABILITIES:

1. Possesses excellent interpersonal communication and negotiation skills in interactions with patients, families, physicians, and health care team colleagues

2. Ability to work with people of all social, economic, and cultural backgrounds and be flexible, open minded, and adaptable to change

3. Capable of independent judgment and action regarding psychosocial needs of patients.

Additional Job Description:

Scheduled Weekly Hours:

40

Shift:

Day (United States of America)

Exempt/Non-Exempt:

United States of America (Exempt)

Company:

SYSTEM West Virginia University Health System

Cost Center:

415 POPH Population Health Management

Address:

608 Cheat Road

Morgantown

West Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively “WVUHS”) is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.