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Nurse Case Management Senior Analyst
Ref No.: 20-02717
Location: Nashville, Tennessee
Pay Rate : $ 35.98 - 35.98 /Hour
Nurse Case Management Senior Analyst

Address: Remote
Hours: Monday-Friday 8:00AM-5:00PM CST

Pay: $32.00-$26.00/hour paid every Friday (unknown until first submission)
Contract Length: 06/15/2020 to 12/31/2020 (extension and permanent placement based on attendance and performance)
Openings: 2
Equipment: Due to WAH position, candidate will receive 2 computer monitors, a computer tower, a C-Live Kit, Aruba box, and desk phone

Overview:
  • Worker must feel comfortable taking a high volume of inbound calls and making outbound calls in between. If they do not have much experience with electronic charting, this is NOT the position for them! Must be able to document while talking on the phone so typing fast is essential.
  • Plans, implements, and evaluates appropriate health care services to assist the customer throughout the continuum of care. 
  • Utilizes clinical skills to assess, coordinate, monitor and evaluate options and services in order to facilitate appropriate health care outcomes for customers. 
  • Responsible for educating and motivating customers to participate in wellness programs. 
  • Support health promotion, disease prevention, and care management services.
 
Essential Duties and Responsibilities:
  • Outreach low to moderate risk customers for coordination of care, including HRA and internal referrals, and continuity of care management.
  • Identify and address customer gaps in care, which may include primary care physician and specialist appointment scheduling. 
  • Provide clinical assessments, health education, and community resources to customers, as needed.
  • Initiate contact with customer/caregiver/family, primary care physician, and health care providers/suppliers as needed. 
  • Develop customer’s individualized plan of care, as well as communicate the plan of care to the customer. 
  • Document all encounters with the customers, practitioners and providers
  • Resolve any immediate issues for customers after screening.
  • Evaluate each case for quality of care, document and report quality issues to the appropriate team.
  • Request medical records as needed, abstract records, and complete data entry.
  • Other duties as assigned.
Skills:
  • Excellent interpersonal and communications skills
  • Strong research and analytical skill
  • Strong time management and organization skills
  • Basic proficiency in Word, Outlook, PowerPoint, Excel
  • Ability to meet deadlines and manage multiple priorities, and effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environments
  • Ability to make decisions on what needs to be done based on clearly established guidelines
  • Spanish language ability is desirable
  • Ability to pass 7-year county background check and urine drug screen (medical marijuana cards approved)
Education:
  • Registered Nurse with minimum 2 years of experience in a hospital or clinic setting required Case Management experience preferred.
  • Medicare and/or Medicaid experience with geriatric populations preferred
  • Experience with community resource organizations
  • Experience handling confidential health care information, with care management software applications
  • Experience managing customers with complex medical and behavioral health concerns preferred