RN Clinical Care Guide (Case Management Exp) - Mesa (On-site)

Blue Cross Blue Shield of Arizona; Mesa (AZ); On-site; USD 70,000 - 90,000; Full time

Job summary

Prosano Health Solutions seeks a Clinical Care Guide (RN) to support patients in navigating referrals and diagnostic testing, delivering patient-centered care onsite at the Care Center in Arizona.

You will educate patients, schedule referrals, and partner with the care team to improve health outcomes while maintaining confidentiality and compliance with privacy standards.

Qualifications

• Current state license to practice as a Registered Nurse (RN).
• BLS certification required.
• Experience with Electronic Medicare Records / EMR systems.

Responsibilities

• Walk-in and virtual member support with real-time consultation, education, scheduling, and follow-up of specialist and diagnostic referrals.
• Manage end-to-end referral or specialist service coordination and provide patient education.
• Lead quality programs and patient outreach to improve outcomes and reduce gaps in care.

Skills

Registered Nurse

BLS Certification

Interpersonal Skills

Empathy & Advocacy

Education

BSN or higher

CCM Certification

AZ RN License

Tools

Electronic Medical Records

EHR Systems

Job description

About Prosano Health Solutions:Prosano Health Solutions, in partnership with Blue Cross Blue Shield of Arizona, has launched an Advanced Primary Care model with a clear mission: To Inspire Health and Make it Easy. Our goal is to deliver affordable, convenient, and personalized care to the communities we serve. Our Advanced Primary Care model is focused on providing a signature patient experience which will raise the bar in both the delivery of care, and by ensuring health equity is top of mind. And, in every market we serve, we assure that a customized, high-value system of care is available for our members. Together, we will set the standard for how healthcare can and should be delivered in our State.Why Join Our Team?Here’s the fun part. We are growing our team. The team will include people who share our passion and deep commitment to taking the primary care experience to a new level. Our team is unified in providing not only comprehensive care, but a truly exceptional patient experience, leaving our patients with the lasting impression of trust and compassion. We realize we can do great things by working together and adapting processes to provide the best possible care for people. Together, we will improve the health within our communities and make a difference in people’s lives.If you share this vision and desire to do something different...we look forward to talking to you!For more information, please reach out to our Talent Acquisition team.Working hours include morning, night, or weekend hours.The position will require to work 100% on-site at the Care Canter locationThis position is Onsite only. This Onsite work opportunity requires residency, and work to be performed, within the State of Arizona.You Will:The Clinical Care Guide (RN) will be a key contributor to our first-class care team at Prosano Health Solutions. They will deliver on our commitment to excellence to our patients and help us grow through their role. The Clinical Care Guide will have end to end responsibility for our specialist and diagnostic testing navigation, as well as in leading and partnering with the care team in supporting patients in their journey toward their best health. This position has an emphasis on customer/patient care excellence, privacy, compliance, and serving in a dynamic health setting.Support members both in-person and virtually with real-time consultation, education, scheduling of specialist & diagnostic referral appointments, and follow-through + follow-up of those appointmentsPlay a critical role in the achievement of improved health outcomes and cost savingsBe an empathetic problem-solver and become the most visible partner to all patientsClarify and explain referral for specialist and diagnostic service recommendationsCare for end to end process as needed, for referral or specialist servicesLead center in development and management of quality programs to include patient outreach to members in an effort to provide an elevated primary care experience with gaps in care or other clinical needsSupport members with chronic conditions by providing education, reminders, and other supportHandle the management and integration of office processesLead service and schedule requests on member’s behalfInform and equip Care Team with referral information and requirementsBe an ambassador in the local community - building relationships with other healthcare providers, social/community organizations, and marketing partnersPerform all other duties as assignedWorking hours include morning, night, or weekend hoursYou Have:Excellent interpersonal skills to include maintaining courteous, friendly and effective communications with patients, team members and external partiesCurrent state license to practice as a Registered NurseBLS certificationElectronic Medicare Records experienceCustomer service orientation and experienceStrong communication skills across multiple modalitiesHighly collaborativeEmpathy and advocacyExceptional organizing skills, detail-orientationMust be able to maintain confidentiality at all timesActive AZ fingerprint clearance cardPreferred Qualifications:Bachelor's degree in Nursing (BSN)Case Management Certification (CCM)Proficiency with other health care related software platformsHigh degree of independence, flexibility, initiative and commitmentOur CommitmentProsano Health Solutions does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.Thank you for your interest in Prosano Health Solutions. If interested in this position, please apply.