PRINCIPAL RESPONSIBILITIES :
This position works under the direct supervision of the Clinical Manager, Enhanced Care Management (ECM) and is responsible for the operational delivery of the plans ECM case management and care coordination programs and processes.
The Enhanced Care Management Nurse will provide oversite of ECM case management services for health plan members with highly complex medical and psychiatric conditions where advocacy and coordination are required to help the member reach the optimum functional level and autonomy.
The ECM Nurse will be working closely with a team comprised of the Health Navigators and external ECM Providers in the community.
This collaborate team approach to case management will include key departments at the health plan, inlcuding Utilization Management and Pharmacy, which may provide clinical expertise and data on patient utilization patterns, often in real time, to the program.
Externally, the team will work closely with community partners to make referrals for care and resources and to best manage members across the care spectrum and among multiple health care systems.
The goal of the ECM program is to improve members quality of life and assure cost-effective outcomes by utilizing all available and appropriate resources.
Principal responsibilities include : mce- "" noto "" sans", "" sans-serif" "" mce- "" noto "" sans", "" sans-serif" "" mce- "" noto "" sans", "" sans-serif" "" mce- "" * mce- "" noto "" sans", "" sans-serif" "" Perform the oversite functions of ECM member assessments, planning, facilitation and advocacy through collaboration with the ECM Providers and other health care resources involved in the members care.
Work closely with licensed and unlicensed staff to co-manage the care of complex cases telephonically through regular contact with members, caretakers, healthcare professionals and others involved in the members careThe nurse will act a subject matter expert on the nursing process and perspective for the team.
The nurse will be responsible for triage and all aspects of the nursing process, including mce- "" mce- ""
Enhanced Care Management, Nurse (Bilingual Preferred)
PRINCIPAL RESPONSIBILITIES: * [[This position works under the direct supervision of the Clinical Manager, Enhanced Care Management (ECM) and is responsible for the operational delivery of the plans ECM case management and care coordination programs and processes. The Enhanced Care Management Nurse w...
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