Lead Disease Management - RN Job at Personify Health

Job Description

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. Will also provide treatment plans and supervise all LVN work. Must be available to work Monday- Friday 8am-5pm and occasional Saturday (if needed)

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
communicate policy and procedural updates
instruct staff on approved methods
and resolve complex or non-routine operational issues
Train and mentor staff on managing patient cases telephonically
Train and mentor staff on patient outreach and comprehensive assessments
Train staff on developing individualized care plans
Train staff on monitoring interventions, evaluating treatment plan effectiveness, and documenting measurable outcomes
Guide staff in patient advocacy
Ensure staff meet established productivity, quality, and daily performance metrics
Maintain readiness for and successfully pass external audits, including URAC and NCQA
Ensure compliance with HIPAA regulations, company policies, confidentiality standards, and minimum necessary requirements
Complete all required annual training within established company timelines
Willingness to travel

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
Proficiency in required systems and tools after training: Microsoft Teams, SharePoint, VPN access tools, UM Web, Health Notes, ADP, Confluence, MyCare, Phone systems utilizing a headset, Smartsheet
Ability to communicate effectively with leadership and team members

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

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Lead Disease Management - RN

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