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Job Title: Complex Case Mgr Job
Job Location: MO: Kansas City
Pay Rate: competitive
Job Length: full time
Start Date: 2012-11-02
Company Name: Coventry Health Care
Contact: Karen Vargas
Phone: Apply Online
Fax: Apply Online
Description: Description:
Coventry Health Care is currently seeking an Advanced Illness Complex Case Manager for our Kansas City, MO location. The Condition Management Program case management model focuses on chronically ill members. The ideal candidate will have experience with working in palliative & hospice care;; a clinical familiarity with a culturally diverse and aged patient population is preferred. This position will provide a holistic approach to case management, including addressing physical, emotional, spiritual & psycho-social needs of members and their families. The Advanced Illness Case Manager will help members and care givers manage daily symptoms,develop the knowledge necessary for self management and medication management working in conjunction with their physicians and other healthcare providers, facilitate an understanding of treatment options and the completion of advanced directives.
GENERAL SUMMARY
:
The selected candidate will coordinate care for members with various co-morbid disease processes and assume responsibility for case management across the continuum including accessing available resources including telephonic and written communication with physicians and other providers.
ESSENTIAL RESPONSIBILITIES:
- Initial assessment and screening of members for enrollment into the Condition Management Program;
- Comprehensive and proactive case management of members with chronic conditions to improve patient quality outcomes and decrease costs;
- Follow nursing process and program guidelines including: assessment, establishing interventions related to goals, case plan evaluation; reporting to team, medical directors and other providers; and calculation of cost savings;
- Assure members receive all necessary care allowed under their benefit plan or alternate funding;
-Work with members and caregivers to understand treatment options;
-Assist members with completing advanced directives;
-Advocate for members to receive care according to membersTM wishes;
- Act as liaison and key resource for Appeals Coordinators for cases involving utilization management, case management, and general medical issues; and
- Maintain confidentiality of members information in accordance with HIPAA regulations.
Qualifications:
JOB SPECIFICATIONS:
Registered nurse with current, unencumbered MO license; BSN preferred, will consider RN with CCM certification and/or at least two years of case management and relevant clinical experience;
Must be able to obtain unencumbered license in other States (Coventry will reimburse);
Excellent proficiency with Windows (Outlook, MS Word and Excel) and healthcare software is required.
Able to document in an accurate and precise manner;
Excellent verbal and written communication skills are a must.
Must be flexible and able to function independently and efficiently in a managed care for-profit environment while working cooperatively with other team members.
Please submit your resume and salary requirements to our online Career Center at
http://jobs.coventryhealthcare.com/
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: Kansas City, MO, US
Organization: 10000 - Coventry Health Care - Corp
Schedule: Full-time
Job Posting: 2012-10-18 00:00:00.0
Job ID: 1211761
Please refer to Job code 2221700A0 when responding to this ad.
For FASTEST PROCESSING of your resume, please visit http://www.jobcircle.com/classifieds/11365022.html?source=ng to apply online.
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