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Field Service Coordinator - RN Job

Company: WellCare
Location: Saint Louis
Posted on: January 15, 2019

Job Description:

Health ServicesCareersSearch JobsHealth Services JobsNursing JobsField Service Coordinator - RNField Service Coordinator - RN JobFull Job Title: Field Service Coordinator, RN - St. LouisJob Number: 1601499Location: St Louis, MODate Posted: 9-20-2016Apply NowChoose a job you love and you will never have to work a day in your Life!!As a Field Service Coordinator, RN with Wellcare, you have the unique opportunity each and every day to bring value and quality to a members life. Your responsibilities will include working with Care Coordination MVP team members to assess, plan, implement, coordinate, monitor, and evaluate services and outcomes to maximize the health of the members.This position requires extensive travel to member homes located in rural areas within St. LouisJob Summary:Works with Care Coordination MVP Team members to assess, plan, implement, coordinate, monitor, and evaluate services and outcomes to maximize the health of the Member. Coordinates, monitors and ensures that appropriate and timely primary, acute and long-term care services are provided to members across the continuum of care. Promotes effective healthcare utilization, monitors health care resources and assumes a leadership role within the Interdisciplinary Care Team (ICT) to achieve optimal clinical and resource outcomes for member. Coordinates the care and services of selected member populations across the continuum of illness. Promotes effective utilization and monitors health care resources. Assumes a leadership role within the interdisciplinary team to achieve optimal clinical and resource outcomes. Works directly with the member in the field, i.e., inpatient bedside, member's home, provider's office, hospitals, etc. while collaborating with management to assess, plan, implement, coordinate, monitor and evaluate services and outcomes to maximize the health of the member.Department: Field Health ServicesReports to: Supervisor, Field Service CoordinationLocation: St. Louis, MissouriEssential Functions:Evaluates members for case management services and determines appropriate level of care coordination/ management services for member.Completes a comprehensive assessment and develops a care plan utilizing clinical expertise to evaluate the members need for alternative services.Acts as a primary case manager for members identified as Complex as defined by Case Management Program Description.Develops and monitors members plan of care, to include progress toward meeting established goals and self-management activities.Interacts continuously with member, family, physician(s), and other providers utilizing clinical knowledge and expertise to determine medical history and current status. Assess the options for care including use of benefits and community resources to update the care plan.Supervises and/or acts as a resource for non-clinical staff (i.e., Service Coordinators and Field Social Workers).Act as liaison and member advocate between the member/family, physician and facilities/agencies.Maintains accurate records of case management activities in the Enterprise Medical Management Automation (EMMA) System using clinical guidelines.Coordinates community resources, with emphasis on medical, behavioral, and social services. Applies case management standards, maintains HIPAA standards and confidentiality of protected health information and reports critical incidents and information regarding quality of care issues.Ensures compliance with all state and federal regulations as well as Corporate guidelines in day-to-day activities.Meets with clients in their homes, work-sites, physician's or hospital to provide management of services.Adapts to changes in policies, procedures, new techniques and additional responsibilities.Participates with other Case Managers and Medical Directors in regular or special meetings such as Clinical rounds.Perform other duties as assigned.*LI-SM1Education:Bachelor's Degree in Health Services or BSN or directly related equivalent work experience.Experience:2-4 years clinical acute care experience.Home health, physicians office or public health experience a plus.At least 1-3 years current case management experience preferred.Managed care experience preferred.Understands the business and financial aspect of case mgmt in a managed care setting.Prior utilization management experience preferred in some geographic regions. Experience in care of the elderly is required in some geographic regions.Licenses/Certifications:Current State RN licensure is required.Maintain required contact hours to fulfill regulatory requirements.CCM strongly preferredSpecial Skills (e.g. 2nd language):Bilingual skills a plusAssists in evaluating process improvementsAbility to work independently, handle multiple assignments and prioritize workloadDemonstrates high level time management and priority settingCommunicates effectively in person and by phoneAbility to work independently in various environmentsAdvanced ability as a licensed professional to communicate on any level required to meet the demands of the positionAbility to create, review and interpret treatment plansUnderstands the business and financial aspect of case mgmt in a managed care settingTechnical Skills/Requirements:Proficient in Microsoft Office including Excel, Word, PowerPoint, Access and Outlook Express.Knowledge of or the ability to learn company approved software such as CRMS, Peradigm, InterQual, Sidewinder and other software in order to perform job duties.Apply NowBack to top

Keywords: WellCare, St. Louis , Field Service Coordinator - RN Job, IT / Software / Systems , Saint Louis, Missouri

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