Overview We\'ve made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. At Ochsner Health, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!
This job manages identified complex/catastrophic patients attributed to the organization and its Network of partner providers. Uses the case management process to assess the healthcare needs of the enrollee, identify barriers to care, develop a comprehensive treatment plan with specific goals and objectives, implement the plan in collaboration with the PCP team and other providers, coordinate services, monitor effectiveness, and modify the plan as needed. The role is part of a multidisciplinary care team and coordinates care among multiple healthcare providers, the patient\'s caregiver(s), community services, payors, and others to ensure seamless services throughout the continuum of care. Arranges and coordinates resources necessary to manage the patient\'s disease processes in the home environment. The job adheres to the CMSA Standards of Practice for Care Management.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.
Education
Required - Graduate of an accredited school of nursing.
Preferred - Bachelor\'s degree in nursing.
Work Experience
Required - 3 years of experience in a clinical setting; experience documenting in an electronic medical record and using Microsoft Office; experience working in a multi-disciplinary team environment.
Preferred - Experience in case management, care coordination or disease management.
Certifications
Required - Current Registered Nurse (RN) License in the state of practice.
Preferred - Certification as a Case Manager (CCM).
Knowledge Skills and Abilities (KSAs)
Proficiency in using computers, software, and web-based applications.
Effective verbal and written communication skills and ability to present information clearly and professionally to varying levels of individuals.
Excellent knowledge of managed care, CMS, Medicaid and other regulatory standards/requirements and ability to use community resources to facilitate patient care throughout the continuum.
Good organizational and time management skills and ability to be self-directed and exercise good judgement.
Job Duties
Collaborates with members of the health care team, the patient, and patient\'s caregiver(s) to develop and implement a coordinated treatment plan across the continuum.
Assesses patient for social determinants of health that may create barriers to care and/or adversely impact care plans; includes SDOH in the care plan and refers to Social Work or Community Health Worker as appropriate.
Uses the case management process to develop comprehensive cost-effective plans of care for patients in care management.
Collaborates with the multidisciplinary team, Primary Care Provider, and other appropriate care providers to facilitate care and treatment.
Coordinates referrals and appointments with members of the care team.
Provides in-depth disease-based patient education and formulates collaborative action plans with patient/caregiver to achieve agreed-upon goals for self-management and improved health status.
Provides community resources to patients, families and/or caregivers to avoid or reduce hospital admissions through telephonic and face-to-face contact.
Identifies quality issues that may adversely affect patient outcomes and submits to department leadership.
Performs other related duties as required.
The above statements describe the general nature and level of work. They are not exhaustive and duties may be added or amended. Remains knowledgeable on current laws, accreditation standards or regulatory requirements applicable to the area of responsibility and ensures compliance.
Compliance & EEO
This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and other compliance-related concerns. The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.
Physical and Environmental Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly. Normal routine may include exposure to blood, body fluids, or tissue. The incumbent works with patients who may have known or suspected communicable diseases and may enter isolation rooms. There may be occupational risk for exposure to hazardous medications or waste. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Are you ready to make a difference? Apply Today!
Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website. Refer to the job description to determine remote vs on-site status. Individuals who reside in and will work from certain areas are not eligible for remote work.
Ochsner Health endeavors to make our site accessible to all users. If you need an accommodation to complete the application process, contact our HR Employee Solution Center at 504-842-4748 (select option 1) or careers@ochsner.org. This contact information is for accommodation requests only and cannot be used to inquire about application status.
Ochsner is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to protected characteristics including protected veterans and individuals with disabilities.