RN / Case Management Exp

Cross Country Nurses Worcester , MA 01601

Posted 3 weeks ago

The benefits of taking a travel nursing job with Cross Country Nurses include:

  • Free Private Housing or Generous Housing Allowance

  • Comprehensive Health Insurance with Prescription Coverage

  • Dependent Health Insurance with Prescription Coverage

  • Competitive Salaries

  • Referral Bonuses

  • Travel Reimbursement

  • Shift Differentials

  • 401(k) Retirement Plan

  • Direct Deposit/Free Checking

  • Unlimited Free CE Credits

  • Minimum Requirements:

  • At Least 1 Year of Recent Acute Care Experience

  • ASN, BSN or MSN Required

Cross Country Nurses has more of the travel nursing jobs that you want. We currently have an opportunity in the Worcester, MA area for a Case Management Exp Registered Nurse (RN), however if this position isn't right for you... don't worry about it. We have new and exciting Case Management Exp assignments coming in every day, in fantastic cities that you will love to experience. Just think of another destination that you've been thinking of exploring and we'll see what type of assignments we have there. From Boston to Austin, Orlando to San Francisco, we have exclusive travel nursing jobs all across the country! Our positions go fast, so call a Recruiter today!

Posted Date: 2021-09-20

  • Job Reference:* 242181
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Responsibilities may include conducting in home face to face visits for member identified as needing face to face visit interaction and assessments with the goal to coordinate and facilitate services to meet member needs according to benefit structures and available community resources. The NCM may conduct assessments and may determine the number of hours' members require for MassHealth programs such as the personal care attendant program, adult foster care, group adult foster care, and other programs per product benefits and guidelines. 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performing a member advocacy and education role including but not limited to member rights * Serves as an advocate for members to ensure they receive Fallon Health benefits as appropriate and if member needs are identified but not covered by Fallon Health, works with community agencies to facilitate access to programs such as community transportation, food programs, and other services available through senior centers and other external partners * Follows department and regulatory standards to authorize and coordinate healthcare services ensuring timeliness in compliance with documented care plan goals and objectives * Assesses the Member's knowledge about the management of current disease processes and medication regimen, provides teaching to increase Member/caregiver knowledge, and works with the members to assist with learning how to self-manage his or her health needs, social needs or behavioral health needs * Collaborates with appropriate team members to ensure health education/disease management information is provided as identified * Collaborates with the interdisciplinary team in identifying and addressing high risk members * Educate members on preventative screenings and other health care procedures such as vaccines, screenings according to established protocols and program processes such initiatives involving Key Metrics outreach * Ensures members/PRAs participate in the development and approval of their care plans in conjunction with the interdisciplinary primary care team * Strictly observes HIPAA regulations and the Fallon Health Policies regarding confidentiality of member information * Supports Quality and Ad-Hoc campaigns Care Coordination and Collaboration * Provides culturally appropriate care coordination, i.e. works with interpreters, provides communication approved documents in the appropriate language, and demonstrates culturally appropriate behavior when working with member, family, caregivers, and/or authorized representatives * With member/authorized representative(s) collaboration develops member centered care plans by identifying member care needs while completing program assessments and working with the Navigator to ensure the member approves their care plan * Manages NaviCare members in conjunction with the Navigator, Behavioral Health Case Manager, Aging Service Access Point Geriatric Support Service Coordinator, contracted Primary Care Providers and others involved/authorized in the member's care * Monitors progression of member goals and care plan goals, provides feedback and works collaboratively with care team members and work effectively in a team model approach to coordinate a continuum of care consistent with the Member's health care goals and needs * Works collaboratively with Fallon Health Pharmacist, referring members in need of medication review based upon Program process * Develops and fosters relationships with members, family, caregivers, PRAs, vendors and providers to ensure good collaboration and coordination by streamlining the focus of the Member's healthcare needs utilizing the most optimal treatment approach, promoting timely provision of care, enhancing quality of life, and promoting cost-effectiveness of care * Actively participates in clinical rounds Provider Partnerships and Collaboration * May attend in person care plan meetings with providers and office staff and may lead care plan review with providers and care team as applicable * Demonstrates positive customer service actions and takes responsibility to ensure member and provider requests and needs are met Regulatory Requirements - Actions and Oversight * Completes Program Assessments, Notes, Screenings, and Care Plans in the Centralized Enrollee Record according to product regulatory requirements and Program policies and processes * Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member education, outreach, and actions in conjunction with the Navigator and other members of the Clinical Integration and Partner Teams Performs other responsibilities as assigned by the Manager/designee Supports department colleagues, covering and assuming changes in assignment as assigned by Manager/designee Qualifications Education Graduate from an accredited school of nursing mandatory and a Bachelors (or advanced) degree in nursing or a health care related field preferred. 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RN / Case Management Exp

Cross Country Nurses