Provides assistance and support to physicians and other medical providers in assessing, planning, and providing patient care and ensuring the delivery of quality care and services. Responsible for conducting patient visits/assessments related to acute and chronic care management. Assist with the development, implementation, management, and achievement of specific programs / site objectives and initiatives, including coding and partnership for quality.
Responsible for conducting patient comprehensive physicals for work-in, walk-in, and other chronic care management visits within a home, clinic or virtual setting. May assist the health plan to gather relevant clinical information, perform member’s physical assessment, document clinical findings, and coordinate with the assigned PCP to obtain needed clinical services and in accordance with approved clinical protocols. May assist physicians with inbound clinical triage and provides direction (notifying physicians, seeing patients, providing verbal orders) to nursing staff regarding treatment of the patient conditions. May manage acute care activities. Identify, develop, and implement clinical protocols and obtain approval from physicians for patient treatment. Conducts relevant patient education and coordinates with health plan programs in all applicable settings. May conduct presentations and community sessions pertaining to disease specific process and wellness.
Health Plan / Field Setting: Proactively coordinates with collaborating physicians and director of the program to implement clinical activities to enhance management of a comprehensive physical exam. Actively inquires and participates in decisions to ensure that all patients are seen timely and as clinically relevant, conducts comprehensive physicals / assessments, and plays an active role in affecting clinical outcomes & performance measures for the program. Documents the clinical finding back to the PCP of record and supplies relevant documentation back to the health plan.
Minimum Requirements: Graduate an accredited program as a Nurse Practitioner (NP), Advanced Practice Nurse (APN), or Physician Assistant (PA). Advanced education and training in the diagnosis and management of common medical conditions and chronic illnesses. Current licensure as a Nurse Practitioner or Physician Assistant in applicable state; license must include prescriptive authority. Current Basic Life Support (BLS). For Clinic Setting, current Advanced Cardiac Life Support (ACLS) Certification.
Preferred Requirements: Coding Certifications (CCS-P, CPC, RHIT, RHIA, CCS). At least two years’ experience in Internal Medicine or Family Practice setting..
CIGNA - 22 months ago
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With a significant position in the US health insurance market, CIGNA covers some 11.5 million Americans with its various medical plans. The...