Acts as a resource and liaison to Primary Care sites to ensure the goals of the CCAs clinical programs are met.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
· Adhere to all applicable compliance requirements and the Code of Conduct
· Provide clinical direction as an integral part of the contractual relationship between CCA and primary care sites. (These will be designated clinical practices).
· Interface with primary care clinical staff on an ongoing basis to review and consult on care coordination and clinical decision making; participate in managing administrative issues.
· Liaison with primary care staff to conduct case management activities.
· Review of patient / member charts and review of care plans.
· In this position, you will also be working with the provider network (e.g. hospitals, nursing homes, community agencies and hospitals), relative to quality or other administrative matters.
· Conducts and attends meetings and works on special projects as requested.
· Develop and conduct trainings for primary care clinical staff and other members of the care teams
· Position requires the ability to travel to primary care provider sites within Massachusetts.
· Periodic coverage for colleagues serving members in the Senior Care Options Program and the Integrated Care Organization
· After hours on call responsibility
· Exceptional customer service and interpersonal skills
· Ability to work effectively in team models
· Work in a fast paced environment
· Ability to work with all levels of personnel
DESIRED SKILLS AND ABILITIES:
· BS in Nursing
· Licensure as a Registered Nurse
· 5-7 years minimum experience
· Experience in care of the geriatric population
· Experience in care management, utilization management, and care delivery systems
Commonwealth Care Alliance - 9 months ago