CareCentrix

  • Nurse Coach- (Remote)

    Job Locations US-CT-Hartford
    Job ID
    2018-6112
    Category
    Post Acute Care / Clinical
  • Overview

    The Nurse Coach utilizes clinical expertise to manage assigned Post-Acute Care patients’ transition from acute care setting to the home setting through telephonic outreach to provide education, coaching and care coordination to accomplish the goals of the Post-Acute Care Program.  

    Responsibilities

    • Engages Post-Acute Care patients in the program and administers initial assessments, progress surveys and discharge surveys in an effort to prevent readmissions. 
    •  Engages Post-Acute Care patient in the program and performs assessments that directly tie to reducing readmissions.These include but are not limited to: Educating members regarding their Discharge Instructions, ensuring a follow up PCP appointment is in place, medication reconciliation, educating on the signs and symptoms of their condition, referral to community resources and caregiver support.
    • Works closely with the Post-Acute Care patient home health agency nurse, and physicians to facilitate education and adherence to establish health care goals and care plan. 
    • Using clinical expertise, reviews utilization information concerning patient care and matches those needs to available care options, within the Post-Acute Care Program and specific plan payer criteria.
    • Documents all interactions, guidance and interventions in applications 
    • Acts as a clinical resource for Post-Acute Care Coordinators, assisting to clarify referral source directives. Receives/responds to requests from unlicensed staff regarding scripted clinical questions and issues.
    • May support on-going reauthorization decisions for Post-Acute Care patients and issues service reauthorizations for the home care provider based on medical necessity and payer benefit guidelines.
    • Contacts referral sources to advise them of referral status. Relays referral status and updates to the assigned health plan case managers.
    • Participates in and contributes to ongoing quality assessment/improvement activities, ensures the collection of data for improvement analysis and prepares reports as requested.
    • Participates in an annual Inter-rater reliability Testing Process
    • Typical work schedule is Monday thru Friday 8am to 6pm. Based on business needs, evening and weekend coverage may be needed at times. 

    Qualifications

    • Associate's or Bachelor’s Degree in Nursing and licensure in the state(s) of practice required.
    • Minimum of 5 years of experience as a Registered Nurse
    • Expertise in Case Management and knowledge of URAC standards 
    • Broad knowledge of health care delivery/managed care regulations, contract terms/stipulations, prior Case Management/review experience, and governmental home health agency regulations required.
    • Excellent negotiation, communication, problem solving and decision making skills also required.

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