Imagine Yourself Here...
At Aurora Health Care we believe that each of us can use our knowledge, experience and creativity to help people live well. We’re a non-profit organization with a clear vision of providing people with better health care than they can get anywhere else. Our strength stems from teamwork and collaboration among a talented and diverse group of professionals.
- Primary Purpose
- Assists in the development and is responsible for the successful implementation of health management services for new The Aurora Network (TAN) clients.
- Acts as the interim Onsite Nurse Case Manager until a permanent case manager is hired and trained.
- Acts as a nurse navigator for TAN employers.
- Provides case management services for a defined population by evaluating the client's needs and requirements to achieve and/or maintain optimal health/wellness.
- Collaborates with a multi-disciplinary team, employing strategies, approaches and techniques to manage health/wellness issues in a patient-centered, coordinated and accessible manner.
- Major Responsibilities
- Competent to function in the onsite nurse case management role. Functions as a nurse navigator for TAN employers. Applies case management processes and workflows to a defined population to achieve desired care outcomes within the framework of patient centered care.
- Executes the implementation plan for health management services for new TAN groups. Collaborates with external partners (employer, sales team, payers/third party administrators, etc.) and internal Aurora partners. Communicates with external and internal implementation partners regarding expectations, tasks and status. Recognizes and resolves issues and understands when and how to escalate issues appropriately. Responsible for creating a positive service experience for the employer and employees by insuring a successful implementation.
- Collaborates with the leadership team to assist in the development of the implementation plan for each employer. Implements Care Management initiatives as appropriate for new contracts/new clients.
- Mentors newly hired Onsite Nurse Case Managers and coordinates the successful transition of services to the permanent Onsite Nurse Case Manager.
- Facilitates communications among patient/family, multi-disciplinary team, medical management team, community resources, and other disciplines, anticipating, identifying, evaluating, and acting to resolve any potential barriers and constraints to delivery of care in a timely manner. Understands and interprets multiple contracts and contractual obligations in order to enable the case management team to achieve maximum clinical and financial outcomes.
- Establishes and maintains effective communication and working relationships with physicians, leadership and caregivers in markets and sites supported by case management services. Responds to concerns and provides problem resolution as appropriate. Establishes relationships with payers to partner in the overall quality and efficiency of care provided to health plan members.
- Monitors and maintains accurate documentation of health/wellness management activities and outcomes.
- Collaborates with the management team in the development of and maintenance of policies, procedures and performance standards related to the Onsite Case Manager.
- Licenses & Certifications
- Registered Nurse license issued by the state in which the caregiver practices.
- Bachelor's Degree (or equivalent knowledge) in Nursing.
- Required Functional Experience
- Typically requires 5 years of experience in case management/health coaching/managed care. Also a minimum of 3 years of clinical nursing experience.
- Knowledge, Skills & Abilities
- Knowledge of Case Management and/or health coaching.
- Excellent interpersonal, diplomatic, negotiation and problem solving skills including the ability to work collaboratively with physicians, employers, payers and brokers.
- Excellent written and verbal communication skills.
- Excellent computer skills including the use of Microsoft-based programs particularly Word and Excel.
- Must be self-directed with the ability to work well independently and within a team environment while recognizing and meeting the individual needs of external and internal partners/customers.
- Ability to work productively and effectively in a complex environment that includes multiple changing priorities.
- Demonstrated critical thinking, analytical problem solving and assessment skills.