Nurse Care Manager- Wilson

Full Time
Greenville, NC 27835
Posted
Job description

Vidant Health

About Vidant Medical Center

Vidant Medical Center is a 900+ bed Level-1 Trauma Center, regional referral hospital and is the flagship hospital for Vidant Health. We serve as the teaching hospital for the Brody School of Medicine at East Carolina University. Vidant Medical Center provides acute, intermediate, rehabilitation and outpatient services to more than 1.4 million people in 29 counties. But it's in our work environment that you'll find our sense of family and closeness that permeates everything we do.

Position Summary

The Panel Manager is responsible for care management for ambulatory patients. They work to manage patients preventive care needs, flag those at risk, improve quality of care and help bridge the gap between clinician and patient. The Panel Manager may also engage in traditional staff nurse work within the ambulatory setting.

Responsibilities

  • Manage/Coordinate care of ACO, Medicaid, Uninsured, and MedCost population within the clinic under the direction of the provider.
  • Aligns efforts and patient care priorities with system care management leadership goals and objectives.
  • Primarily responsible for ensuring providers and practice team members receive communication about care management/population health activities, goals, objectives, and outcomes.
  • Ensure all stable ACO, Medicaid, MedCost, and Uninsured patients are seen by the provider at least once per year (or more if required) to ensure appropriate clinical care, documentation of conditions, risks, appropriate attribution, and HCC coding.
  • Monitors ACO, Medicaid, MedCost, Payor Pay for Performance, and other quality outcomes at the practice and provider panel level and develops improvement plans to reach goals.
  • Reviews reports and data to identify patients with care gaps and personally reaches out to schedule patients with the provider, health coach, annual wellness nurse, and/or other care management resources.
  • Prepares charts in advance to ensure successful completion of clinical care related to ACO, Medicaid, and MedCost patients. Leads daily huddle to ensure alignment of practice resources and daily plans.
  • Concludes the day with a review and determination if all care gaps for the day have been closed.
  • Review the Medicaid patient list and reconcile with the PHP monthly.
  • Collaborate with the health coach or central care management team to ensure scheduling alignment of coordinating for care such as reducing emergency room utilization and post discharge follow up appointments.

Minimum Requirements

  • Registered Nurse
  • Graduate of approved School of Nursing and holds a current license to practice in the state of North Carolina, BSN Preferred
  • BLS Certified

General Statement

It is the goal of Vidant Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.

Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.

We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant's qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.

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