Schenectady or Rochester, New York - Posted on: Monday 09/16/13
Under the direction of the Condition Heath Management Supervisor; The Clinical Health Coach/Certified Case Manager/RN will telephonically assess, identify needs, coordinate, educate, case manage and/or coach members with various disease states while working cooperatively and effectively with the MVP Health care delivery system to assure high quality, cost effective care for these members. Is responsible for improving health outcomes for members with chronic illness such as Asthma, Chronic Obstructive Pulmonary Disease, Chronic Low Back Pain, Coronary Artery Disease, Heart Failure, Cancer, Diabetes, Depression and End Stage Renal Disease. Responsible for identification, engagement and stratification of members targeted for various disease states and assuring that members receive care that meets MVP’s quality and safety standards. Will develop, facilitate and communicate a plan of care in partnership with the member, family, the primary or attending physician and vendors that both optimize the quality of life and care for the member and develop member centric goal statements. Will document plan of care/goals aimed at minimizing risk for the patient, employer and the plan and will provide routine monitoring of
member progress at set intervals. Monitor and review cases with medical director to assure appropriate outcomes. Other duties as assigned by supervisor.
- Bachelor's degree in Nursing, New York State RN Licensure required and 3 years clinical experience or
Associates Degree in Nursing, New York State RN licensure required with 7 years of recent clinical experience.
- Certification in Case management (by CCMC) and/or Health Coaching/Wellness certification required within 24 months after hire.
- Demonstrated clinical experience in and knowledge of population health management/disease management
- Ability to communicate independently and directly with members, providers and staff with calmness, assertiveness, diplomacy and in a non-confrontational manner
- Excellent oral and written communication skills, including ability to compose correspondence
- Excellent computer skills including strong working knowledge of Word, Windows based applications and the internet
- Detail oriented with strong organizational skills.
- A “team” player able to work well in an energetic, dynamic and deadline oriented environment.
- Previous experience required in situations demanding strict adherence to confidentiality.
- Must be able to solve problems while exhibiting clinical judgment and realistic understanding of the current environment.
- Must be able to make independent decisions about appropriateness, resource utilization, and quality of care without supervisory assistance except in unusual circumstances.
- Must demonstrate understanding of clinical and psychosocial issues that may alter treatment or care plan and be able to demonstrate good judgment when dealing with emotionally charged situations.