RN Case Manager/Quality Specialist

Salary: starting at $30/hr

No Nights, Holidays, or Weekends!! ;)

Scope-Purpose

The purpose of this position is to serve as a core member of the MO HealthNet Health Home and Patient Centered Medical Home (PCMH) teams and to be intimately involved with all aspects of these programs. The RN Case Manager will promote overall patient health by providing, delegating, evaluating and coordinating comprehensive professional nursing care.

Responsibilities (included, but not limited to):

Approximate work responsibilities 75% Case Manager, 25% Quality Specialist

• Participate in the initial treatment plan development for all of the primary care health home enrollees
• Assure provision of intensive monitoring, follow-up, and clinical management of high-risk patients
• Assist in developing treatment plan health care goals for individuals with co-occurring chronic diseases
• Assist in contacting medical providers & hospitals for admission/discharge summaries and completing medication reconciliations
  
• Provide training on medical diseases, treatments & medications
• Track required assessments and screenings
• Assist in implementing MHD health technology programs & initiatives (i.e., CyberAccess, metabolic screening, depression screening, interfacing with DRVSand EMR/PM for identification, design and implementation of methods to collect date to facilitate tracking of PCMH functions)
• Monitor HIT tools & reports for treatment
  
• Monitor & report performance measures & outcome

Quality improvement and assurance tasks to include but not limited to:

• Monthly performance reporting using DRVS and Excel
• Performance improvement initiatives for MCOs, ACO, patient engagement, other payer and quality programs
• Reporting and compliance submissions for UDS, PCMH
• Lead process improvements
• Serve as resource expert for clinical support staff providing education and process support for quality measure compliance
• DRVS superuser
• Assist with other quality tasks as assigned

Education and Experience Requirements

• Current RN license recognized by the State of Missouri Board of Nursing
• Current BLS certification
• Strong experience with clinical application software
• Knowledge of nursing care in accordance with regulations and practices established by the Missouri Board of Nursing
  
• Health Educator, Certified Diabetes Educator certification, or case management certificationpreferred

Benefits

• Health Insurance Fordland Clinic pays 90% of an individual employees monthly premium costs, and a significant portion of alternate plans for employee only, employee + spouse, employee+ child(ren), or family coverage.
• Dental Insurance Fordland Clinic offers affordable dental insurance, as well as a buy up option for those anticipating higher expected dental expenses.
• Vision Insurance that includes coverage options for eye exams, glasses as well as contact lenses.
• Life Insurance Fordland Clinic Provides $15,000 of life insurance to its employees at no cost to the employee. Additional life insurance coverage for employees, their spouse and children are also available at group pricing.
• Aflac Products Employees have the option of purchasing additional products such as long-term disability, short term disability, accident, and other insurance products at group rates through our Aflac representative.
• Generous PTO
• Bereavement Leave and Extended Sick Bank time
• Retirement 403(b) retirement option with employer matching
• Continuing Education Reimbursement Fordland Clinic supports employees efforts to remain up to date on required certifications and skills. Reimbursement for job related certifications and continuing education is available based on Fordland Clinic guidelines.
  
• Fitness Benefit Fordland Clinic encourages health and wellbeing and will contribute up to $100 per year for a fitness facility membership, or other approved fitness expenses.
• Thank You recognition program through Motivosity, redeemable for gifts and gift cards.

Work hours: Full-time, hourly position. In order to maintain full-time status, a minimum of 30 hours per week on average are required, though 40 hours a week will be expected for this position. Work schedule is usually weekdays only (May work 4 - 10hour shifts or 5 - 8hour shifts)