WVU Medicine
Peak Focused Disease Management Coordinator Population Health
WVU Medicine, Core, West Virginia, United States, 26529
Peak Focused Disease Management Coordinator Population Health
3 days ago Be among the first 25 applicants
Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position.
Minimum Qualifications
Associate’s Degree in Nursing AND Seven (7) years clinical experience in a healthcare setting OR Bachelor’s Degree in Nursing AND Five (5) years clinical experience in a healthcare setting.
Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC).
State criminal background check and Federal (if applicable), as required for regulated areas.
Obtain certification in Basic Life Support within 30 days of hire date.
Preferred Qualifications
Bachelor’s Degree in Nursing.
Prior care coordination experience.
Core Duties and Responsibilities
Ambulatory Utilization Management, Financial Management and Quality Screening for assigned patients.
Identify the targeted population and risk stratify all patients to prioritize needs and direct interventions.
Communicate and collaborate with inpatient and outpatient case management to implement the discharge plan and coordinate a safe transition to the next level of care.
Work in collaboration with physicians/providers, patients, and their families to ensure safe and efficient transitions of care.
Work collaboratively with patients to design an individualized plan of care that ensures coordination of services by the healthcare team.
Collaborate with available social services for appropriate resource and financial management which may include, but is not limited to financial assistance coordination/referrals, entitlement program coordination/referrals, patient benefit coordination, assessment for appropriate usage of Health Care Resources/clinical cost efficiency.
Coordinate/facilitate patient progression throughout the continuum, Transitional Planning, Advocacy and Education.
Clinical performance improvement, outcome management and quality activities.
Use data to drive decisions and plan/implement performance improvement strategies for assigned patients, including fiscal, clinical and patient satisfaction data.
Implement clinical interventions based on risk stratification and evidence-based clinical guideline adherence and promote best practice by initiating/adjusting therapies as directed by the practitioner and providing appropriate follow-up monitoring as needed.
Coordinate appropriate laboratory and diagnostic testing.
Continuously evaluate laboratory results, diagnostic tests, utilization patterns and other metrics to monitor quality and efficiency results for assigned population.
Participate in development, implementation, evaluation and revision of clinical pathways and other tools.
Educate the multidisciplinary team and physicians about clinical pathways/protocols and managed care principles.
Work with leadership to design, implement, and evaluate a centralized care model that optimizes value. Work with leadership to continuously evaluate process, identify problems, and propose process improvement strategies.
Monitor clinical and financial indicators on an ongoing basis and take action to achieve continuous improvement in both areas.
Physical Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Working Environment
Office and clinical settings.
Skills And Abilities
Possesses excellent interpersonal communication and negotiation skills in interactions with patients, families, physicians, and health care team colleagues.
Ability to work with people of all social, economic, and cultural backgrounds and be flexible, open minded, and adaptable to change.
Capable of independent judgment and action regarding psychosocial needs of patients.
Additional Job Description Exempt. Primarily Remote. Insurance experience recommended. Monday-Friday 8:00-4:30.
Important Details
Scheduled Weekly Hours: 40
Shift: Day (United States of America)
Exempt/Non-Exempt: United States of America (Exempt)
Company: SYSTEM West Virginia University Health System
Cost Center: 415 SYSTEM Population Health Management
#J-18808-Ljbffr
Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position.
Minimum Qualifications
Associate’s Degree in Nursing AND Seven (7) years clinical experience in a healthcare setting OR Bachelor’s Degree in Nursing AND Five (5) years clinical experience in a healthcare setting.
Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC).
State criminal background check and Federal (if applicable), as required for regulated areas.
Obtain certification in Basic Life Support within 30 days of hire date.
Preferred Qualifications
Bachelor’s Degree in Nursing.
Prior care coordination experience.
Core Duties and Responsibilities
Ambulatory Utilization Management, Financial Management and Quality Screening for assigned patients.
Identify the targeted population and risk stratify all patients to prioritize needs and direct interventions.
Communicate and collaborate with inpatient and outpatient case management to implement the discharge plan and coordinate a safe transition to the next level of care.
Work in collaboration with physicians/providers, patients, and their families to ensure safe and efficient transitions of care.
Work collaboratively with patients to design an individualized plan of care that ensures coordination of services by the healthcare team.
Collaborate with available social services for appropriate resource and financial management which may include, but is not limited to financial assistance coordination/referrals, entitlement program coordination/referrals, patient benefit coordination, assessment for appropriate usage of Health Care Resources/clinical cost efficiency.
Coordinate/facilitate patient progression throughout the continuum, Transitional Planning, Advocacy and Education.
Clinical performance improvement, outcome management and quality activities.
Use data to drive decisions and plan/implement performance improvement strategies for assigned patients, including fiscal, clinical and patient satisfaction data.
Implement clinical interventions based on risk stratification and evidence-based clinical guideline adherence and promote best practice by initiating/adjusting therapies as directed by the practitioner and providing appropriate follow-up monitoring as needed.
Coordinate appropriate laboratory and diagnostic testing.
Continuously evaluate laboratory results, diagnostic tests, utilization patterns and other metrics to monitor quality and efficiency results for assigned population.
Participate in development, implementation, evaluation and revision of clinical pathways and other tools.
Educate the multidisciplinary team and physicians about clinical pathways/protocols and managed care principles.
Work with leadership to design, implement, and evaluate a centralized care model that optimizes value. Work with leadership to continuously evaluate process, identify problems, and propose process improvement strategies.
Monitor clinical and financial indicators on an ongoing basis and take action to achieve continuous improvement in both areas.
Physical Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Working Environment
Office and clinical settings.
Skills And Abilities
Possesses excellent interpersonal communication and negotiation skills in interactions with patients, families, physicians, and health care team colleagues.
Ability to work with people of all social, economic, and cultural backgrounds and be flexible, open minded, and adaptable to change.
Capable of independent judgment and action regarding psychosocial needs of patients.
Additional Job Description Exempt. Primarily Remote. Insurance experience recommended. Monday-Friday 8:00-4:30.
Important Details
Scheduled Weekly Hours: 40
Shift: Day (United States of America)
Exempt/Non-Exempt: United States of America (Exempt)
Company: SYSTEM West Virginia University Health System
Cost Center: 415 SYSTEM Population Health Management
#J-18808-Ljbffr