Nurse Intellectual Disabilities Care Manager
Provides telephonic and/or on-site assessments for the Maine ASO utilization review program and the Maine PASRR program. Assessment and utilization review for members with intellectual disabilities, co-morbid medical conditions, and other related conditions.
1. Provides telephonic and/or on-site utilization review for members with intellectual disabilities; medical comorbidity, and other related conditions.
2. Conducts assessments, provides specialized service recommendations as needed.
3. Collaborates with member’s medical/health and community based providers (including the PCP, HCH, behavioral health specialists, or others as needed) regarding the member’s treatment needs and plan of care.
4. Collects clinical data and enters information into database for tracking and metrics purposes.
5. Monitors and evaluates the services and community based resources necessary to respond to the individual member’s health needs.
• Education required is a minimum of an Associate Degree in nursing with specific training and/or work experience within the intellectual disability field, Bachelor of Science in nursing preferred
• Minimum 3+ years clinical experience required
• Previous experience working with members with intellectual disabilities; candidate will have care management, quality improvement, medical record reviews, disease management and/or case management experience
• Knowledge of Medicare/Medicaid
• Knowledge of job specific medical specialty (Intellectual Disabilities)
• Knowledge of community based resources
• Clinical assessment skills, consistent with state licensure scope of practice requirements
• Excellent written & verbal communication skills
• Telephonic skills
• Proficient in Microsoft Office, Internet/Web Navigation
• Prioritization and organizational skills
• Ability to assess patient health status, consistent with state licensure scope of practice requirements
• Ability to integrate data and evaluate to design meaningful interventions
APS Healthcare - 20 months ago