In this role, the selected candidate will be responsible for performing all functions of Utilization Management (UM), Case Management (CM) and Disease Management (DM) and is a single source of contact for members, health care personnel and all other entities.
In this role, you will communicate with injured employees, medical professionals, claims staff and others to obtain information necessary to make sound medical assessments regarding diagnosis and prognosis.
In this role, the selected candidate will be responsible for performing all functions of Case Management (CM) and Disease Management (DM) and is a single source of contact for members, health care personnel and all other entities involved in managing care.
In this role, the successful candidate will assess injury severity, extent of disability, treatment plans, functional abilities and physical job requirements to establish target return to work plans and/or strategy to manage future medical exposure.
The RN Case Manager consults as needed with the physician and the office giving details about patient care. Performing accurate OASIS collection, ensuring the medication profile remains current, ensuring lab values have been reported to the physician timely, attending weekly case conference and monthly case manager meetings are key responsibilities of this role.
In this role, you will be responsible for managing THPGs primary care population for high risk and/or chronic illness patients via creation of pro-active care plans promoting effective education of red flags signs/symptoms and medications as well as self-management to improve patient engagement and adherence to PCPs plan of care by facilitating access and timely healthcare delivery to achieve cost effective, optimal quality, and financial outcomes.
In this role, you will be responsible for selecting, orienting, training, assigning, scheduling, coaching, counseling, and disciplining nursing employees in collaboration with the Practice Manager/Administrator.