Care Manager RN 1 QA

Company: Baylor Scott & White Health
Location: Dallas
Posted on: May 28, 2023

Job Description:

JOB SUMMARY
The Care Manager RN 1 QA will be accountable for assessing and coordinating patient care across the continuum, utilizing accepted criteria and guidelines to manage benefits and resolve medical necessity of services provided. This position will function as a clinician, case manager, and educator to achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization.
Location: Dallas, TX - Medprovider Clinic- 3417 Gaston Ave, Dallas, TX 75246
Setting: Case Management
Schedule: FT Monday- Friday , 9am-5:30pm - must sit onsite
ESSENTIAL FUNCTIONS OF THE ROLE

• 
  
• 
  Assesses plans, implements, documents, coordinates, monitors, evaluates and updates the plan of care by partnering with all members of the health care team to provide evidenced based care.
  
  
• 
  Establishes patient care management plans, interventions, treatment goals and self-management goals.
  
  
• 
  Assesses the health care, educational and psychosocial needs of the patient and family.
  
  
• 
  Assists patients with self-management through education, visits and telephonic engagement; encourages and helps patient adherence to their care plans.
  
  
• 
  Researches, evaluates and recommends resources to meet medical and non-medical needs of patients and families. Partners, refers and communicates across all programs to ensure appropriate coordination of services.
  
  
• 
  Researches and takes an effective role in identifying problems and possible solutions in the coordination of care to resolve most appropriate setting.
  
  
• 
  Acts as liaison to hospitals, primary care providers, post-acute partners and specialists.
  
  
  KEY SUCCESS FACTORS
  
  • 
    
  • 
    Specialty Certification highly encouraged.
    
    
  • 
    Knowledge of care management, resource and utilization management.
    
    
  • 
    Skilled in care management and patient assessments.
    
    
  • 
    Excellent verbal and written communication skills required.
    
    
  • 
    Ability to monitor, assess and record patient progress against a plan of care.
    
    
  • 
    Ability to facilitate patient access to community resources.
    
    
  • 
    Ability to work collaboratively with both internal and external medical staff and external partners and organizations.
    
    
  • 
    Ability to assess, adjust, and calmly respond to changing and crisis environment.
    
    
  • 
    Ability to maintain confidentiality with all aspects of patient information in accordance with all applicable policies and regulations.
    
    
    BENEFITS
    Our competitive benefits package includes the following
    
    • 
      
    • 
      Immediate eligibility for health and welfare benefits
      
      
    • 
      401(k) savings plan with dollar-for-dollar match up to 5%
      
      
    • 
      Tuition Reimbursement
      
      
    • 
      PTO accrual beginning Day 1
      
      
      Note: Benefits may vary based upon position type and/or level
      QUALIFICATIONS
      
      • 
        
      • 
        EDUCATION - Associate's
        
        
      • 
        EXPERIENCE - 2 Years of Experience
        
        
      • 
        CERTIFICATION/LICENSE/REGISTRATION -
        
        
        &nbspRegistered Nurse (RN)
        As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

Keywords: Baylor Scott & White Health, Dallas , Care Manager RN 1 QA, Healthcare , Dallas, Texas