Clinical Integration Nurse Case Manager - Remote-Territory Cape Cod area
Company: Fallon Community Health Plan
Location: Barnstable
Posted on: April 9, 2021
|
|
Job Description:
Clinical Integration Nurse Case Manager - Remote-Territory Cape
Cod areaUS-MA-BarnstableJob ID: 6301Type: Full Time# of Openings:
1Category: NursingRecruiting Location - Barnstable (Cape 1),
MAOverviewPassionate about the Elderly? Looking for No Weekends/ No
Holidays & Work/Life Balance? Interested in Case Management and
stepping away from bedside care? About Fallon HealthFounded in
1977, Fallon Health is a leading health care services organization
that supports the diverse and changing needs of those we serve. In
addition to offering innovative health insurance solutions and a
variety of Medicaid and Medicare products, we excel in creating
unique health care programs and services that provide coordinated,
integrated care for seniors and individuals with complex health
needs. Fallon has consistently ranked among the nation's top health
plans, and is accredited by the National Committee for Quality
Assurance for its HMO, Medicare Advantage and Medicaid products.
For more information, visit fallonhealth.org.About NaviCare:Fallon
Health is a leader in providing senior care solutions such as
NaviCare, a Medicare Advantage Special Needs Plan and Senior Care
Options program. Navicare integrates care for adults age 65 and
older who are dually eligible for both Medicare and MassHealth
Standard. A personalized primary care team manages and coordinates
the NaviCare member's health care by working with each member, the
member's family and health care providers to ensure the best
possible outcomes. Brief Summary of Purpose: The Nurse Case Manager
(NCM) is an integral part on an interdisciplinary team focused on
care coordination, care management and improving access to and
quality of care for Fallon members. NCM seeks to establish
telephonic and/or face to face relationships with the
member/caregiver(s) to better ensure ongoing service provision and
care coordination, consistent with the member specific care plan
developed by the NCM and Care Team. 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. The NCM may
utilize an ACD line to support department and incoming/outgoing
calls with the goal of first call resolution with each interaction.
ResponsibilitiesMember Assessment, Education, and
AdvocacyTelephonically assesses and case manages a member panel May
conduct in home face to face visits for onboarding new enrollees
and reassessing members, utilizing a variety of interviewing
techniques, including motivational interviewing, and employs
culturally sensitive strategies to assess a Member's
clinical/functional status to identify ongoing special conditions
and develops and implements an individualized, coordinated care
plan, in collaboration with the member, the Clinical Integration
team, and Primary Care Providers, Specialist and other community
partners, to ensure a cost effective quality outcomeCare
Coordination and CollaborationProvides 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 representativesWith 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 planQualificationsEducationGraduate from an
accredited school of nursing mandatory and a Bachelors (or
advanced) degree in nursing or a health care related field
preferred. License/CertificationsLicense: Active, unrestricted
license as a Registered Nurse in Massachusetts & current Driver's
license and a vehicle to be used for home visitsCertification:
Certification in Case Management strongly desiredOther:
Satisfactory Criminal Offender Record Information (CORI) results
Experience 1+ years of clinical experience as a Registered Nurse
managing chronically ill members or experience in a coordinated
care program required Fallon Health provides equal employment
opportunities to all employees and applicants for employment and
prohibits discrimination and harassment of any type without regard
to race, color, religion, age, sex, national origin, disability
status, genetics, protected veteran status, sexual orientation,
gender identity or expression, or any other characteristic
protected by federal, state or local laws. JT18 PI133330996
Keywords: Fallon Community Health Plan, Nantucket , Clinical Integration Nurse Case Manager - Remote-Territory Cape Cod area, Executive , Barnstable, Massachusetts
Click
here to apply!
|
Didn't find what you're looking for? Search again!
Other Executive JobsManagement Consultant Description: Job Description Management Consulting been the foundation of Point B's employee-owned company for 25 years. Our collaborative, forward looking leadership approach ensures our customers are on the right (more...) Company: Point B Location: Boston Posted on: 04/21/2021 Account Manager Description: Major Clients Account Manager br br Professional Staffing Group is one of the largest Boston based staffing firms and due to our growth, we are looking to add an Account Manager to our major clients (more...) Company: Professional Staffing Group Location: Jamaica Plain Posted on: 04/21/2021 Business Development Manager Description: OverviewRanked among the nation's top 10 Construction Managers by Engineering News-Record, The LiRo Group provides integrated construction, design, and technology solutions for a broad range of public (more...) Company: The LiRo Group Boston MA Location: Boston Posted on: 04/21/2021 Major Clients Account Manager Description: Major Clients Account Manager br br Professional Staffing Group is one of the largest Boston based staffing firms and due to our growth, we are looking to add an Account Manager to our major clients (more...) Company: Professional Staffing Group Location: Charlestown Posted on: 04/21/2021 GMP QA Manager Description: GMP QA Senior Manager, 1095267 Job Scope Purpose We are seeking a GMP QA Manager to oversee quality systems pertaining to manufacturing and regulatory activities for clinical material. This includes management (more...) Company: Apex Systems Location: Lexington Posted on: 04/21/2021 Account Manager Description: Major Clients Account Manager Professional Staffing Group is one of the largest Boston based staffing firms and due to our growth, we are looking to add an Account Manager to our major clients team to (more...) Company: Professional Staffing Group Location: Woburn Posted on: 04/21/2021 Assistant Retail Store Manager Great Mall Milpitas Milpitas, Ca Description: Contribute to the sales profitability Company: Swarovski Retail Ventures Location: Lexington Posted on: 04/21/2021 Project Manager - Healthcare Payer Description: Req ID: 114006 br br NTT DATA Services strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking (more...) Company: NTT DATA Corporation Location: Wellesley Posted on: 04/21/2021 Nurse Director, Adult Psychiatry Epstein 4 Description: Job DescriptionThe Nurse Director is accountable and responsible for clinical operations on a 24-hour basis. She/he is responsible to coordinate day-to-day Company: Mass General Brigham Location: Saugus Posted on: 04/21/2021 Lead Technical Project Management Description: Job DescriptionCompany Description Epsilon is the leader in outcome-based marketing. We enable marketing that's built on proof, not promises. Through Epsilon PeopleCloud, the marketing platform for personalizing (more...) Company: Epsilon Location: Wakefield Posted on: 04/21/2021 |