RN- Case Management (Remote) Position Available In Coos, New Hampshire

RN- Case Management (Remote)

Job Summary:

The Medical Practice RN/LPN Care and Clinical Coordinator is responsible for working collaboratively with a multidisciplinary care team across the healthcare continuum in the outpatient setting. This includes but is not limited to, managing patients with chronic conditions, promoting wellness and ensuring smooth transitions of care. Focuses efforts on decreasing preventable ED visits and readmissions while improving patient satisfaction. She/he will be responsible for ACO and Quality incentive programs as well as clinical quality, oversight, coordination, and standardization. The RN/LPN care and clinical coordinator is responsible for optimizing workflow and improving efficiency. Remote/hybrid available.

Essential Job Functions:

Assists with the management of chronic care patients, provides health teaching, advocacy, counseling and assistance to a group or population of patients including but not limited to chronic care patients, high risk for readmission and support what is in the best interest of the patient.
Support ACO initiatives and support the provision of staff education relative to quality improvement. Responsible for working on quality initiatives with insurance carriers to promote wellness and shared savings.
Promote healthy behaviors in all populations and ensure navigation assistance with community resources.
Promote quality driven work processes that optimize workflow and improve office efficiency.
Promote a culture of shared responsibility in which processes are standardized across clinics. Work in conjunction with practice managers to achieve improvement.
In conjunction with healthcare providers as well as other leaders strive to establish efficient clinical processes as it relates to ACO initiatives and quality improvement.
Promote a work environment which fosters the acceptance of positive change initiatives.
Demonstrates professional practice behavior.
Demonstrates understanding in use of IT resources and patient databases.
Works closely with all primary care teams, hospital department staff, home health agencies and other care coordinators to ensure the patients experience a smooth transition of care across all health care settings.
Work in conjunction with palliative care provider, including but not limited to processing incoming palliative care referrals, scheduling palliative appointments, providing follow up with palliative care patients.

Education Requirements:

Registered Nurse Degree or LPN license required.