RN Care Manager - Population Health & Care Coordination

Presbyterian Healthcare Services; Albuquerque (NM); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Tuition reimbursement

Scholarship opportunities

Safety badge

Shift differentials

Malpractice insurance

Loan forgiveness

EPIC electronic charting

Job summary

Presbyterian Healthcare Services in Albuquerque, NM is seeking a dedicated Case Management nurse to independently facilitate care for identified populations using assessment, care planning, implementations, coordination, monitoring and evaluation for cost effective and quality outcomes.

Responsibilities include evaluating referrals, conducting comprehensive assessments, developing and documenting plans, and promoting resource use across the care continuum with collaboration across health care

Qualifications

• Associates degree in Nursing, Business, or Health related field required.
• NM nursing license required.
• CPR certification.
• Five years of experience in clinical nursing with 3–5 years in case management, utilization management, quality assurance, home care, community health, or occupational health.
• CCM certification or within 3 years of hire.
• Computer knowledge to include Windows, word processing and database systems.
• Ability to analyze trends based on decision support systems.
• Business management skills including cost/benefit analysis, negotiation, and cost containment.
• Knowledge in referral coordination to community and private/public resources

Responsibilities

• Identifies cases appropriate for case management. Educates providers and other PHS/PHP departments on case management services. Screens new referrals for case management appropriateness.
• Conducts in-depth assessment including psychosocial, physical, medical, environmental and financial parameters. Advocates for members in caseload.
• Formulates, implements, coordinates, monitors, and evaluates strategies for patients and families with member, families and health care team. Develops, documents and implements plan to address social, physical, mental, emotional, spiritual needs.
• Participates in development of clinical guidelines and pathways and incorporates processes into case management role.
• Educates providers on health management strategies to reduce need for one-on-one case management services.
• Facilitates team approach to care across continuum; collaborates with physicians and ancillary services.
• Refer patients to inpatient, outpatient, and community resources.
• Promotes appropriate use of resources to improve quality of care and patient satisfaction; generates reports showing cost-savings and outcomes.
• Complies with Case Management Society of America Standards and CCMC code of professional conduct.
• Performs other functions as required.

Skills

Case management

Utilization management

Quality assurance

Home care

Community health

Occupational health

CCM certification

Nursing license

CPR certification

Data analysis

Cost analysis

Education

Associates degree in Nursing or Health field

Tools

Windows

Word processing

Database systems

Job description

Presbyterian Healthcare Services in Albuquerque, NM is seeking a dedicated Case Management nurse to independently facilitate care for identified populations using assessment, care planning, implementations, coordination, monitoring and evaluation for cost effective and quality outcomes.

Responsibilities include evaluating referrals, conducting comprehensive assessments, developing and documenting plans, and promoting resource use across the care continuum with collaboration across health care