This job was posted by https://www.vermontjoblink.com : For more information, please see: https://www.vermontjoblink.com/jobs/1159151

Job Description

• Perform assessment and/or care management interventions for the referred and identified population
• Ability to travel frequently to members homes, hospitals, PCP office practices and other sites where patients receive care

{=html} <!-- --> - Provide targeted health education to the enrollee, and their family members/caregivers about available benefits, community resources, health care alternatives, and the importance of proactive disease and/or condition management approaches healthcare and wellness. - Assist clinical disease management team with establishing and maintaining efficient and effective communication processes with vendors providing home interventions for Tufts Health Plan membership. - Complies with departmental workflow and documentation policies and procedures

{=html} <!-- --> - Facilitate communication between the care manager and the enrollee and the enrollee with their practitioners to promote empowering the enrollee to take an active role in managing their health

{=html} <!-- --> - Communicates with all providers, actively involved in the enrollees care, regarding individualized care plan progress, specific program participation, and complex case management interventions

{=html} <!-- --> - Perform in-person outreach visits in assigned geographic region and throughout the state as necessary for purposes of engagement and enhanced care coordination with enrollees, providers, and other collateral supports

{=html} <!-- --> - Maintain goals and objectives of Tufts Health Plan in working with all enrollees for the coordination of services for the above enrollee population

{=html} <!-- --> - Work in close collaboration between the behavioral health care managers, social care managers, and other department and division-wide colleagues to provide integrated care for at-risk enrollees

{=html} <!-- --> - Continuously assess the enrollees needs and updates the plan of care per established policies and procedures

{=html} <!-- --> - Attend activities including clinical and other professional organization events as needed

{=html} <!-- --> - Maintain professional growth and development through self-directed learning activities and involvement in professional, civic, and community organizations

{=html} <!-- --> - Maintain an active Massachusetts profession-specific license in good standing without restrictions

Qualifications what you need to perform the job

COVID Policy

Please note: We encourage all Point32Health colleagues to follow CDC guidance about COVID-19 vaccines, boosters, isolation and masking. Point32Health reserves the right to adjust its requirements in response to COVID-19 trends in the communities we serve.

Education, Certification and Licensure

• Registered Nurse with current unrestricted license in state of residence
• May be required to obtain other state licensure in states where Point32Health operates
• Bachelors Degree in Nursing preferred
• National certification in Case Management desirable

Experience(minimum years required):

• 5+ years relevant clinical experience
• Experience in home care or case management preferred
• Proficiency in second language desirable
• Experience in specialty areas such as oncology, neurology, chronic condition/disease management a plus

Skill Requirements

• Skill and proficiency in technical concepts and principles; computer software applications
• Skilled in assessment, planning, and managing member care
• Advanced communicat on and interpersonal skills
• Independent and autonomous with key job functions
• Ability to address multiple complex issues
• Flexibility and adaptability to changing healthcare environment
• Ability to organize and prioritize work and member needs
• Demonstration of strong clinical and critical thinking skills

Working Conditions and Additional Requirements(include special requirements, e.g., lifting, travel):

• Must be able to work under normal office conditions and work from remote office as required.
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
• Ability to make face to face visits (member home, provider practices, facilities) as needed to meet the member needs and produce positive outcomes
• Valid Drivers license and vehicle in good working condition as some travel required
• May be required to work additional hours beyond standard work schedule.
• Other duties as assigned and needed by the department

The above statements are intended