Chronic Condition Care Professional

Job Description

The role of the Chronic Condition Care Professional is to utilize clinical nursing experience to develop a plan for meeting healthcare needs of patients, while continuing to professionally grow in healthcare knowledge and perspective.

In this key role, the ideal candidate will be responsible for utilizing medical knowledge to assess patient needs and provide individualized coaching for the purpose of developing a plan for meeting healthcare needs and patient goals of self-management of chronic medical conditions.

The Chronic Condition Manager is accountable for telephonic assessment, planning, implementation, coordination, education, monitoring, evaluation, and outcomes measurement. The professional maintains privacy and confidentiality in accordance with policies and procedures.

Duties and Responsibilities:

• Assess the patient's medical and psychosocial status, including environmental and cultural influences.
• Determine economically responsible options available to meet the patient's medical and care needs.
• Collaborate with physician(s), provider(s), and patient/family and payers to facilitate quality, timely, and efficient medical care across the healthcare continuum.
• Implement disease management plans by coordinating resources, including community resources, healthcare providers, and significant others.
• Evaluate the disease management plan and its effects on the patient and make modifications as necessary.
• Improve health outcomes and quality of life with reduced complications and costs for persons with chronic health conditions.

Requirements:

• A registered nurse with a current unrestricted license to practice in the state or in a state that has licensure reciprocation with the state of the office location where the employee is working.
• Successful completion of disease management orientation program.
• Minimum of 2 years full-time equivalent of direct clinical care to the consumer.
• Excellent communication skills.