Disease Management Nurse Job at MJHS (New York)

Lead Disease Management - RN

Provide daily direction and communication to case management staff through motiv...

Location

United States

Salary:

38.00 - 40.00 USD / Hour

Personify Health

Expiration Date

Until further notice

Requirements

RN California Licensure required
Minimum of five 3-5 years medical/surgical or acute care experience, including prior supervisory experience, or an equivalent combination of education and experience
2 plus years’ experience in case management preferred
Basic computer literacy, including proficiency with keyboarding and navigating multiple screens simultaneously
Proficient typing skills
Proficiency in common business software applications, including Microsoft Word, Microsoft Excel, and Outlook
Strong verbal and written communication skills
Ability to clearly articulate complex or technical information and accurately interpret information provided by others
Ability to work independently and utilize written resources, policies, and procedures to resolve issues and solve problems
Working knowledge of medical claims processes and medical coding systems, including ICD-10, CPT, and HCPCS

Job Responsibility

Provide daily direction and communication to case management staff through motivation, coaching, counseling, training, quality control review and problem-solving
Coordinate care and services and develop patient treatment plans for catastrophic cases
Provide treatment plans and supervise all LVN work
Provide daily leadership, direction, and communication to Chronic Disease Management (CDM) staff
Collaborate with management to establish and maintain workflows, procedures, and processes
Exercise sound judgment in escalating department-level or employee-related concerns
Monitor, audit, and analyze staff performance
identify performance gaps
develop and implement corrective action plans
Plan, organize, and distribute work assignments

What we offer

Competitive base salary and benefits effective day one
Comprehensive medical and dental through our own health solutions
Paid Time Off
Mental health support, retirement planning, and financial protection
Professional development with clear career progression and learning budgets
Mission-driven culture where diverse perspectives drive real impact on people's health

Fulltime

Chronic Disease Management-rn

As a Full-Time Disease Management Nurse, you will telephonically coordinate well...

Location

United States

Salary:

31.00 - 40.00 USD / Hour

Personify Health

Expiration Date

Until further notice

Requirements

Graduation from an accredited RN program and possession of a current United States RN license
Prior experience in case management, coordinating wellness programs, or an equivalent combination of education and experience
Strong written and verbal communication skills
Proficient in Microsoft Excel, Word, PowerPoint and Outlook
Demonstrate ability to work independently with excellent judgment
Excellent interpersonal and communication skills including able to give presentations to groups and individuals as needed
Good time management skills, highly organized

Job Responsibility

Contact targeted member for health promotion and restoration by the use of national care guidelines to compare patient’s current level of care with industry standards
Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health
create an individual care plan for each patient
provide close follow-up with patients actively managed
Work with patients to ensure they have a primary care provider
assist in referrals to specialists if needed
assist in obtaining durable medical equipment, review pricing for high-cost drugs
Evaluate and make referrals for case management, prenatal program or pharmacology review as indicated
Document interventions and patient contact
maintain privacy of member’s records and assist in providing quarterly reports to clients

What we offer

Comprehensive medical and dental coverage
Mental health support and wellness programs
Flexible work arrangements
Retirement planning support
Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection
Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage
Professional development opportunities and clear career progression paths
Mentorship from industry leaders
Learning budget
PTO policy

Fulltime

Advanced Practice Nurse, NP, Cardiometabolic Weight Management

Caring for new and follow up Cardiometabolic and Weight Management patients. Mon...

Location

United States , Elgin

Salary:

54.90 - 82.35 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Active RN and APRN/APRN-FPA/APNP or other APRN license(s) in state(s) of practice
Active national board certification in area of clinical practice and populations served
Active DEA registration prior to hire
If Illinois practice: active Illinois Controlled Substance License prior to hire
Active BLS and/or ACLS, PALS, NRP as required by clinical practice prior to or within 6 months of hire
Master’s Degree in Nursing
Demonstrated high level of clinical proficiency, and excellent decision-making skills
Demonstrated ability to work independently and as an effective member of a health care team
Demonstrated ability to adapt to evolving technology and proficiency with the electronic medical record
Excellent communication skills

Job Responsibility

Assesses, diagnoses, and determines/alters treatment and management plans appropriate for age, acuity and clinical condition
Manages conditions based on clinical indication, evidence-based care, cost effectiveness, and assessment of risks/benefits and alternatives
Provides health promotion, disease prevention and disease management counseling and education of patients and families
Manages patients as part of an interdisciplinary team and within scope of practice
Maintains accurate, complete, concise, and timely documentation in the electronic medical record
Facilitates consistent, coordinated care and clear communication among all members of the healthcare team and/or health or community agencies
Performs office or hospital procedures in accordance with specialty practice, competency and granted privileges
Participates in quality, safety, and peer review initiatives/performance activities, organizational and/or departmental meetings and committees, peer review, and workgroups as necessary
Participates in education and/or onboarding of new team members, students, and other health care professionals
Seeks experiences to maintain and develop clinical and professional skills and advance the profession within and outside of the organization

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Parttime

Physician Assistant or Nurse Practitioner- Interventional Pain Management

Join us and reimagine health care. Advocate Health, the third-largest nonprofit ...

Location

United States , South Milwaukee

Salary:

54.90 - 82.35 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Physician Assistant license issued by the state in which the caregiver practices
Physician Assistant (PA-C) certification issued by the National Commission on Certification of Physician Assistants (NCCPA)
Registered Nurse license issued by the state in which the caregiver practices
Nurse Practitioner (ANCC) certification issued by the American Nurses Credentialing Center (ANCC)
Nurse Practitioner (AANP) certification issued by the American Academy of Nurse Practitioners (AANP)
Drug Enforcement Administration (DEA) registration issued by the Drug Enforcement Administration (DEA) Registration
Basic Life Support (BLS) for Healthcare Providers certification issued by the American Heart Association (AHA)
Bachelor's Degree in Physician Assistant
Master's Degree in Nursing
Demonstrated high level of clinical proficiency, and excellent decision-making skills

Job Responsibility

Evaluates, diagnoses, treats, and manages acute, critical and chronic patients illness and diseases within an outpatient clinic setting
Obtains medical histories, conducts physical examinations and assesses and determines differential diagnosis
Prescribes medication, therapy and treatments accordingly
Interprets and evaluates patient data for the purpose of determining management and treatment of patients
Performs minor surgeries and routine procedures
Consults with physician as appropriate
Orders, performs, and interprets diagnostic studies in the field of clinical specialty trained and determined competent by a physician
Adjusts patient care plan by reviewing and monitoring treatments and therapy plans
Counsels, instructs and educates patients on physical and mental health including: diet, preventive health measures, health behaviors, self-care skills, disease, treatment options, and normal growth and development
Provides care coordination, which includes managing a variety of ancillary services, pre-operative plans, discharge planning, provider referrals and medical devices such as insulin pumps, defibrillators, and pacemakers

What we offer

Continuing medical education flexibility
Access to fully integrated continuum of care
Structured on-boarding program for new graduates and practicing APCs
Variety of opportunities
On-going professional development
Competitive salary and benefits
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave

Fulltime

Utilization Review Nurse Health Plans - HP Utilization Management

The Utilization Review Nurse is responsible for determining the clinical appropr...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

Graduate of an accredited school of vocational nursing or equivalent required
Associate’s (ADN) or Bachelor’s (BSN) in Nursing preferred
3 – 5 years of nursing experience preferred
Experience in Microsoft software (e.g., Outlook, Teams, Word, and Excel) required
General computer knowledge and capability to use computers required
LVN license in the state of employment or compact required
RN license in state of employment or compact preferred

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
The prior authorization role completes an assessment of a proposed service to determine if the beneficiary has eligible coverage for the service and if it is medically necessary
Promote quality, cost-effective outcomes through prior authorization and concurrent review of requested services for medical necessity based upon evidence-based clinical guidelines
Identify and present cases of possible quality of care deviations, questionable admissions, and prolonged lengths of stay to the Medical Director for further determination
Appropriately refer beneficiaries who have complex or chronic conditions, a need for transition of care, disease management support, or other identifiable needs for coordination of the beneficiary’s member’s health care for behavioral health care management
Follow CHRISTUS Health Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent, or detect unauthorized disclosure of Protected Health Information (PHI)
Protect the confidentiality of data and intellectual property
assures compliance with national health information guidelines
Analyze clinical information submitted by medical providers to evaluate the medical necessity, appropriateness, and efficiency of the use of medical services, procedures, and facilities
Perform provider outreach to address post-hospital discharge services, redirection to in-network providers for appropriate steerage, durable equipment usage, and utilization of other medical services and/or procedures and other necessary telephonic follow-up

Fulltime

Registered Nurse, Center for Childhood Liver Disease

At Boston Children’s Hospital, the quality of our care – and our inclusive hospi...

Location

United States , Boston

Salary:

81078.40 - 174584.80 USD / Year

Boston Children's Hospital

Expiration Date

Until further notice

Requirements

BSN
2 years pediatric nursing experience preferred
Liver disease/GI experience preferred
MA RN License

Job Responsibility

Function in the Center for Childhood Liver Disease (CCLD) and also provide clinical care to core GI patient population including management of enteral tubes
Provide clinical care to patients with both acute and chronic liver disease
Work with director of CCLD and other members of the liver team in program development including development of patient management protocols, coordination of new patient referrals, development of patient education materials, and clinical research
Interact with liver transplant coordinators for care coordination
Provide patient education, assessment, and phone triage/EPIC in-basket management for liver and general GI patients
Act as a clinical resource
Communications with patients, families, and health care providers
See patients at both Longwood and Needham campuses 4 days, Mon- Thurs, 730a-6p

What we offer

Flexible schedules
Affordable health, vision and dental insurance
Child care and student loan subsidies
Generous levels of time off
403(b) Retirement Savings plan
Pension
Tuition and certain License and Certification Reimbursement
Cell phone plan discounts
Discounted rates on T-passes

Fulltime

Nurse Practitioner or Physical Assistant - Virtual Weight Management

Nurse Practitioner or Physical Assistant - Virtual Weight Management - Full Time...

Location

United States , New Berlin

Salary:

54.90 - 82.35 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Active RN, and APRN/APRN-FPA/APNP or other APRN license(s) in state(s) of practice
Active national board certification in area of clinical practice and populations served
Active DEA registration prior to hire
If Illinois practice: active Illinois Controlled Substance License prior to hire
Active BLS and/or ACLS, PALS, NRP as required by clinical practice prior to or within 6 months of hire
Master’s Degree in Nursing

Job Responsibility

Assesses, diagnoses, and determines/alters treatment and management plans appropriate for age, acuity and clinical condition. This includes ordering, performing, and interpreting appropriate diagnostic studies and prescription of pharmacologic and non-pharmacologic interventions and therapies
Manages conditions based on clinical indication, evidence-based care, cost effectiveness, and assessment of risks/benefits and alternatives
Provides health promotion, disease prevention and disease management counseling and education of patients and families
Manages patients as part of an interdisciplinary team and within scope of practice. Seeks physician or other healthcare team member consultation or referrals as appropriate. Escalates need for more emergent or specialized care when necessary
Maintains accurate, complete, concise, and timely documentation in the electronic medical record. Substantiates and submits professional services consistent with compliant coding and billing practices
Facilitates consistent, coordinated care and clear communication among all members of the healthcare team and/or health or community agencies
Performs office or hospital procedures in accordance with specialty practice, competency and granted privileges (where applicable)
Participates in quality, safety, and peer review initiatives/performance activities, organizational and/or departmental meetings and committees, peer review, and workgroups as necessary
Participates in education and/or onboarding of new team members, students, and other health care professionals
Seeks experiences to maintain and develop clinical and professional skills and advance the profession within and outside of the organization

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Nurse Practitioner or Physical Assistant - Virtual Weight Management

Location

United States , New Berlin

Salary:

54.90 - 82.35 USD / Hour

Advocate Aurora Health

Expiration Date

Until further notice

Requirements

Active RN, and APRN/APRN-FPA/APNP or other APRN license(s) in state(s) of practice
Active national board certification in area of clinical practice and populations served
Active DEA registration prior to hire
If Illinois practice: active Illinois Controlled Substance License prior to hire
Active BLS and/or ACLS, PALS, NRP as required by clinical practice prior to or within 6 months of hire
Master's Degree in Nursing
No experience required

Job Responsibility

Assesses, diagnoses, and determines/alters treatment and management plans appropriate for age, acuity and clinical condition. This includes ordering, performing, and interpreting appropriate diagnostic studies and prescription of pharmacologic and non-pharmacologic interventions and therapies
Manages conditions based on clinical indication, evidence-based care, cost effectiveness, and assessment of risks/benefits and alternatives
Provides health promotion, disease prevention and disease management counseling and education of patients and families
Manages patients as part of an interdisciplinary team and within scope of practice. Seeks physician or other healthcare team member consultation or referrals as appropriate. Escalates need for more emergent or specialized care when necessary
Maintains accurate, complete, concise, and timely documentation in the electronic medical record. Substantiates and submits professional services consistent with compliant coding and billing practices
Facilitates consistent, coordinated care and clear communication among all members of the healthcare team and/or health or community agencies
Performs office or hospital procedures in accordance with specialty practice, competency and granted privileges (where applicable)
Participates in quality, safety, and peer review initiatives/performance activities, organizational and/or departmental meetings and committees, peer review, and workgroups as necessary
Participates in education and/or onboarding of new team members, students, and other health care professionals
Seeks experiences to maintain and develop clinical and professional skills and advance the profession within and outside of the organization

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

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Disease Management Nurse

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