Concentra is looking for a dynamic RN Clinical Care Coordinator to work 8am to 5pm Monday thru Friday in our Primary Care Practice in Lincolnwood, IL. . The primary responsibilities include participating in chronic disease management education, participating in data entry and manipulation to monitor performance improvement initiatives and working with leadership to improve access to health services, particularly for the uninsured Care Coordinators achieve these goals by working with our patients to identify and modify psychological, behavioral, emotional and social factors important to maintenance of their holistic health and their ability to access care.
MAJOR DUTIES AND RESPONSIBILITIES:
- Provides service for patients of adult and geriatric age groups and medicare population.
- Healthcare Effectiveness Data and Information (HEDIS) Champion
- Pre-visit record planning – ID HEDIS reminders, DXs to be updated, follow-up on diagnostic and consultation reports
- Responsible for referral and pre-authorization coordination. Coordinates patient appointments with network providers and follow up with providers to obtain timely reports
- Provide patient education using and discuss self–management goals with the patient and assists them in selecting appropriate goals to create an action plan
- Monitor and document goals selected and follow-up with patient by phone, email or in person to determine if goals are achievable and provide assistance to the patient when needed in how to achieve their goals
- Facilitate connections to community support groups and resources
- Maintains contact with patient while hospitalized
- Post discharge plan and follow-up and coordination
- Participates in multi-discipline team conferences and mandated service training programs
- Maintains records and correspondence in orderly well kept files
- Informs supervisor of any management or operating problems that may affect quality and standards of patient services
- Provides comprehensive monitoring of all patient cases to ensure timely and thorough medical treatment and access
- Demonstrates respect for the privacy and confidentiality of patient’s medical records and visits
- Health plan experience in utilization management and/ or quality improvement would be a plus.
- Frequent contact with patients, colleagues and outside agencies
- Frequent exposure to communicable diseases and other conditions common to a health center environment – High Risk OSHA category
- Requires adherence to Infection Control Standard Precautions
- Effective communication and interaction with employers, patients, providers, and other colleagues
- Nurse Case Management experience preferred
- Working knowledge of clinical operations and/or utilization management
- Basic knowledge of HEDIS/CMS Stars
- Competent computer skills required
- Ability to write read and understands instructions, add, subtract, multiply and divide number using whole number, common fractions and decimals
- Requires the ability to compute rate, ration and percent and to draw and interpret bar graphs
- Establish and maintain working relationship with all levels of colleagues
- Above average organizational skills
- Excellent customer service skills
- Professional/positive attitude
- Ability to exchange information on factual matters, schedule appointments, greet patient, explain policies of the facility and/or relay patient’s needs to appropriate personnel
- Role requires providing direct patient care to adult and geriatric patients
- Graduate of an approved Registered Nursing program
- Current registration/license in the state where employed
- Medical coding experience is preferred
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, special disability or medical or veteran status in accordance with federal law. In addition, Concentra Inc. complies with applicable state and local laws prohibiting discrimination in employment in every jurisdiction in which it maintains facilities. This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.
- Minimum 5-7 years of related experience
- Proven experience in verbal and written communication and case management service skills
- Proven ability to function effectively as a member of an interdisciplinary team
- This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.
Concentra's Data Protection Commitment
* Concentra is committed to protect patient data and to ensure privacy of personal and medical information.
* Every Concentra colleague has the responsibility to adhere to data protection principles.
* If a colleague's role includes handling or processing sensitive data, role-specific policies and requirements apply to ensure the protection of patient information.
Concentra Managed Care, Inc. is the leading provider of healthcare management and cost containment services to the workers' compensation,...