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Nurse Coach- (Remote)

Expired Job

Carecentrix Hartford , CT 06183

Posted 3 months ago

Overview

The Nurse Coach utilizes clinical expertise to manage assigned Post-Acute Care patients' transition from acute care setting to the home setting through telephonic outreach to provide education, coaching and care coordination to accomplish the goals of the Post-Acute Care Program.

Responsibilities

  • Engages Post-Acute Care patients in the program and administers initial assessments, progress surveys and discharge surveys in an effort to prevent readmissions.

  • Engages Post-Acute Care patient in the program and performs assessments that directly tie to reducing readmissions.These include but are not limited to: Educating members regarding their Discharge Instructions, ensuring a follow up PCP appointment is in place, medication reconciliation, educating on the signs and symptoms of their condition, referral to community resources and caregiver support.

  • Works closely with the Post-Acute Care patient home health agency nurse, and physicians to facilitate education and adherence to establish health care goals and care plan.

  • Using clinical expertise, reviews utilization information concerning patient care and matches those needs to available care options, within the Post-Acute Care Program and specific plan payer criteria.

  • Documents all interactions, guidance and interventions in applications

  • Acts as a clinical resource for Post-Acute Care Coordinators, assisting to clarify referral source directives. Receives/responds to requests from unlicensed staff regarding scripted clinical questions and issues.

  • May support on-going reauthorization decisions for Post-Acute Care patients and issues service reauthorizations for the home care provider based on medical necessity and payer benefit guidelines.

  • Contacts referral sources to advise them of referral status. Relays referral status and updates to the assigned health plan case managers.

  • Participates in and contributes to ongoing quality assessment/improvement activities, ensures the collection of data for improvement analysis and prepares reports as requested.

  • Participates in an annual Inter-rater reliability Testing Process

  • Typical work schedule is Monday thru Friday 8am to 6pm. Based on business needs, evening and weekend coverage may be needed at times.

Qualifications

  • Associate's or Bachelor's Degree in Nursing and licensure in the state(s) of practice required.

  • Minimum of 5 years of experience as a Registered Nurse

  • Expertise in Case Management and knowledge of URAC standards

  • Broad knowledge of health care delivery/managed care regulations, contract terms/stipulations, prior Case Management/review experience, and governmental home health agency regulations required.

  • Excellent negotiation, communication, problem solving and decision making skills also required.

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Nurse Coach- (Remote)

Expired Job

Carecentrix