Medicaid Managed Care Nurse
- ALL PHS Locations, NC, 27510 - All PHS Nursing
- Hourly
- Other
Medicaid Managed Care Nurse
All PHS Locations
PRN (work on a per diem basis)
Position is mainly remote after completion of training. There will be times that you will come onsite for meetings on an as needed basis.
JOB SUMMARY |
The primary role of the Managed Care Team Lead is to provide clinical expertise for specific complex and/or rising risk patient populations with a design to meet specific contractual and program related requirements. This role will perform disease management, assessment of disease, care plan development and facilitation, referral to appropriate levels of care, etc. The role functions as an integral part of an interdisciplinary team, ensuring excellence with transitions of care to achieve optimal clinical outcomes through a seamless model of access and care. Focus on improving the health status and care for individuals with chronic conditions with complex medical, mental health and psychosocial issues. In collaboration with the care managers, the RN identifies plans and executes activities to promote effective care management and to ensure compliance according to policies and procedures. This position will serve as a resource and health educator for the patient. |
MINIMUM QUALIFICATIONS |
Education: Current, Active, unrestricted Registered Nurse license in North Carolina Experience: Experience in clinical or community resource settings; Care coordination and/or case management experience is preferred Highly organized with ability to keep accurate notes and records • Experience with health IT systems and reports is desirable. Skills: Must possess knowledge and skills necessary to treat patients. Ability to manage care of patients remotely with staff from multiple health centers. May travel at times. In additional to clinical knowledge, position requires strong organizational and interpersonal skills. Type of Employees Supervised: None Licensure, Registry or Certification Required: Active, unrestricted registered nurse license; Valid NC driver's license. Immunizations: Be medically cleared for communicable diseases and have all immunizations up-to-date prior to beginning employment. |
PATIENT POPULATION SERVED |
Medicare |
PHYSICAL DEMANDS/ WORKING CONDITIONS |
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