POSITION SUMMARY: The Outpatient Case Manager is responsible for patient triage, care planning and follow up.
SIGNIFICANT RESPONSIBILITIES & ACCOUNTABILITIES:
Adheres to and supports the mission, purpose, philosophy, objectives, policies, and procedures of Tenet Physician Resources.
Adheres to the Tenet HIPAA Compliance Plan and the Privacy Standards Confidentiality Agreement.
Demonstrates support for the Tenet Physician Resources Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner.
Assists patients with chronic diseases in order to achieve improved health outcomes and enhance patientï¿½s healthcare experience and lower healthcare costs.
Advocates with community resources for additional services that are not covered by the patientï¿½s insurance plan or if the patient has special needs.
Promotes behavior change towards compliance with provider-directed treatment plans.
Engages patients and family members on self- management, setting short and long term goals.
Identifies gaps or barriers to care by working with the patients PCP care team as needed.
Maintains chart documentation to ensure all information about visit is completed and documented correctly.
POSITION QUALIFICATIONS (including required licenses/certifications, education and job knowledge/experience):
Completion of an accredited Nursing Program.
Current State RN nursing license. Current CPR certification.
Minimum of five yearsï¿½ experience a case manager role.
Basic understanding of medical terminology.
Knowledge of medical office procedures and process.
Knowledge of clinical equipment, supplies, and instruments.
Understanding of documentation required for physician office visits.
Knowledge of the purposes, organization, and policies of the local community's health systems sufficient to interact with other health care providers.
Knowledge of the policies and procedures of a clinic sufficient to provide effective patient care.
Must have good understanding of industry standards around disease management such as NCQA.
Strong medical knowledge and competence in chronic disease pathophysiology, polypharmacy, clinical assessment, and patient/family education.
Demonstrated ability to problem solve and manage professional relationships.
CUSTOMER SERVICE RESPONSIBILITIES:
Performs duties while demonstrating strong, interpersonal and communication skills that allows work to flow in a positive, constructive, and professional manner. Works with all team members to facilitate congenial and professional working relationships with subordinates, peers, and superiors thus creating a harmonious work environment. Ensures that all contacts with patients, senior leadership, managers, the public, physicians and other personnel are carried out in a friendly, courteous, helpful and considerate manner. Answers telephones in a prompt and courteous manner. Displays concern and provides assistance or explains procedures as appropriate to callers or in face-to-face situations. Dedicated to meeting the expectations and requirements of internal and external customers. Works with customers to identify problem areas and recommend solutions.
PHYSICAL, MENTAL & ENVIRONMENTAL DEMANDS:
To comply with the Rehabilitation Act of 1973 the essential physical, mental and environmental requirements for this job are listed below. These are requirements normally expected to perform regular job duties. Incumbent must be able to successfully perform all of the functions of the job with or without reasonable accommodation.
Primary Location: Worcester, Massachusetts
Facility: Staff St Vincent Phy Svs
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 2005004449
About Staff St Vincent Phy Svs
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.