At APS Healthcare, we are passionate about changing behaviors of all constituents in the healthcare system to improve health, optimize clinical quality, and reduce associated costs. Our mission, quite simply, is to improve the health of those we serve.
APS Healthcare will be providing both field-based and telephonic case management services for WellCare Ohio, a managed care company serving approximately 100,000 CFC Medicaid members within a seven-county area around Cleveland. Field-based case management services will be provided by multi-disciplinary teams made up of RNs, Licensed Clinical Social Workers, and Care Coordinators/Health Educators, supported by a telephonic case management team in our Columbus OH service center. These teams will work with the members who are at highest risk within the population and will work in various hospitals, provider offices, and, in certain instances of high acuity, a member’s home to assess continuing needs, make referrals to community resources and coordinate social service needs. Frequent contact and quarterly assessments will be provided, so that these members can get coordinated, well-managed care.
APS is looking for a field based RN Care Manager to support this exciting program. The RN will provide on-site outreach, disease and/or case management, education and support to plan members to support healthy lifestyle choices & to reduce long term effects of chronic illnesses. The Care Manager will perform clinically based activities to coordinates care between the members, providers and community based health organizations. This position will be based remotely from a home office and requires travel within Cuyahaga, NE Lorain, W. Lake and N. Medina counties and to the Columbus office for training. The hours will vary from 8am – 7pm with possible Saturdays as needed for members.
Responsibilities:
· Conducts assessments, develops treatment plans and interventions and sets goals for treatment plans/behavioral modification within the scope of practice.
· Collaborates with member’s medical/health and community based providers (including the PCP, HCH, certified dieticians, behavioral health specialists, or others as needed) regarding the member’s treatment needs and plan of care.
· Collects clinical data and enters information into database for tracking and metrics purposes.
· Monitors and evaluates the services and community based resources necessary to respond to the individual member’s health needs.
Qualifications:
· Associates Degree in Nursing required, BSN/MSN preferred
· Current, unrestricted RN licensure in OH is required.
· Minimum 3 years as staff nurse (acute care, case management). Previous experience in a discharge planning, case management, quality improvement, medical record reviews, disease management strongly preferred.
· Knowledge of Medicare/Medicaid.
· Knowledge of adult learning and behavior change principles preferred.
· Knowledge of community based resources.
· Clinical assessment skills, consistent with state licensure scope of practice requirements.
· Excellent written & verbal communication skills.
· Strong telephonic interviewing skills.
· Proficient in Microsoft Office, Internet/Web Navigation.
· Strong prioritization and organizational skills.
· Ability to assess patient health status, consistent with state licensure scope of practice requirements.
· Must be able to integrate data, prioritize and target interventions, consistent with state licensure scope of practice requirements designed to support long term behavioral change.
