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. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.
At Ochsner, 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. It uses the case management process to assess healthcare needs, identify barriers to care, develop a comprehensive treatment plan with goals and objectives, implement the plan in collaboration with the PCP team and other providers, negotiate and coordinate services, monitor and evaluate effectiveness, and adjust the plan as needed. The role is part of a multi-disciplinary care team coordinating care among providers, the patient\'s caregiver(s), community services, payors, and others to ensure seamless services across the continuum of care. It arranges and coordinates resources to manage the patient\'s disease processes in the home environment and adheres to CMSA Standards of Practice for Care Management.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. 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 care continuum.
Good organizational and time management skills and ability to be self-directed and demonstrate good judgement.
Job Duties
Collaborates with health care team, patient, and patient\'s caregiver(s) to develop and implement a coordinated treatment plan across the continuum.
Assesses Social Determinants of Health (SDOH) that may create barriers to care and/or impact care plans; include SDOH in the plan and refer 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.
Coordinates with the multidisciplinary team, Primary Care Provider, and other care providers to facilitate appropriate care and treatment.
Coordinates referrals and appointments with care team members.
Provides in-depth disease-based patient education and formulates collaborative action plans with patient/caregiver to achieve self-management goals and improve health status.
Provides community resources to patient, families, and/or caregivers to avoid or reduce hospital admission through telephonic and face-to-face contact.
Identifies quality issues that may adversely affect patient outcomes and reports to department leadership.
Performs other related duties as required.
The description above outlines the general nature and level of work. It is not an exhaustive list of duties. Contents may change at the company\'s discretion. Remains knowledgeable on current laws, accreditation standards, and regulatory requirements applicable to the area and ensures compliance.
Compliance and Equal Opportunity
This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or 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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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 to move objects.
Normal routine involves no exposure to blood, body fluid or tissue, but exposure or potential for exposure may occur.
The incumbent works with patients who have known or suspected communicable diseases and may enter isolation rooms. There may be an occupational risk for exposure to communicable diseases.
Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste.
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.
Please refer to the job description to determine whether the position is remote or on-site. Individuals who reside in and will work from the following areas are not eligible for remote work: Colorado, California, Hawaii, Illinois, Maryland, Minnesota, New Jersey, New York, Vermont, Washington, and Washington D.C.
Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please 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 the status of applications.
Ochsner is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to any legally protected class, including protected veterans and individuals with disabilities.