Implements strategies to achieve and ensure patient follow-up according to clinical strategic measures/outcomes. Coordinates, educates and counsels patients and families regarding preventative care, medical problems and the use of various treatments for specific medical conditions. Responsible for managing patient's health status across the continuum of care. Works under general supervision with latitude for initiative and independent judgment. Reports to the director of Prime Dx.
PRINCIPAL DUTIES AND RESPONSIBILITIES
Performs on-site and telephonic disease management assessments and follow-up interventions.
Communicates and coordinates on-going health care services with physicians.
Implements strategies to ensure patient follow-up.
Develops patient/family educational plans to promote self-management.
Coordinates ongoing educational needs of patients and their families as related to their disease and self-management.
Assists the patient/family with integrating the implications of the illness recovery and health promotion into their lifestyle.
Instructs and counsels patients/families regarding the disease and its relation to preventive care, medical problems, psychological problems and the use of various treatments.
Interprets plan documents for utilization review, case management, disease management and healthcare elements.
Travels up to 30% of the time to Houston, Victoria, Austin and surrounding areas.
Maintains client and subscriber confidentiality at all times.
Performs other duties as assigned.
Experience and Education
Bachelor’s degree and current RN license in the State of Texas is required. At least five years of medical/ surgical/ hospital experience is essential.
Experience performing case and disease management.
Certification as a Case Manager.
Background in patient education.
Knowledge, Skills, and Abilities
Knowledge of business correspondence, filing and general office procedures.
Knowledge of current healthcare protocols.
Knowledge of ICD-9 and/or CPT-4 codes.
Skill with standard office operating equipment and various Microsoft Office applications.
Skill in organization.
Skill in interpersonal and written communication.
Ability to accurately compile data and perform detailed work.
Ability to meet deadlines.
Ability to maintain regular attendance.
Ability to maintain confidentiality of material and information.
Ability to maintain professional appearance and demeanor.
Ability to work as a member of a team.
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