What are the responsibilities and job description for the Clinical Case Manager RN position at Hines & Associates Inc?
Job Overview
Hines & Associates Inc is seeking a highly skilled Clinical Case Manager RN to join our team. In this key role, the ideal candidate will utilize their clinical nursing experience to develop and implement personalized care plans for patients with chronic medical conditions.
Duties and Responsibilities:
- Conduct thorough assessments of patient's medical and psychosocial status, identifying potential issues and developing strategies to address them.
- Determine economically responsible options for meeting patient's medical needs, ensuring timely and efficient access to quality care.
- Collaborate with healthcare providers, payers, and patients to facilitate seamless care coordination across the continuum.
- Implement disease management plans by coordinating resources, including community services, healthcare providers, and significant others.
- Evaluate the effectiveness of disease management plans and make adjustments as necessary to improve health outcomes and quality of life.
- Promote patient self-management of chronic health conditions through education, motivation, and support.
- Stay up-to-date with clinical practice guidelines and best practices in care management.
- Communicate effectively with TPAs, insurers, physicians, patients, and other healthcare providers, utilizing assertiveness when necessary.
- Provide written documentation regarding patient status, treatment plans, and disease management interventions.
- Interface with Utilization Management, Case Management, and peer review programs, as indicated on active cases.
- Maintain confidentiality, promote safety, and adhere to policies and procedures, URAC standards, and regulatory requirements.
- Support special projects assigned by supervisor.
