RN Outpatient Care Manager - Covington

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.

Webelieve 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!

The Manager manages complex/catastrophic patients assigned to Ochsner Network Primary Care Physicians. Utilizes the Case Management process to assess the health care needs of the enrollee, develop a comprehensive treatment plan complete with specific goals and objectives, implement a treatment plan in collaboration with the PCP team and the other providers involved in the patient's care, negotiate and coordinate services for the patient, monitor and evaluate the effectiveness of the plan in achieving the goals and objectives, and change and modify the plan as needs and situations change.

This job is embedded within the Primary Care Practice and participates as a key team member in the Patient Centered Medical Home. Assumes responsibility for coordinating care among multiple healthcare providers, the patient's caregiver(s), community services, payors, and others involved in the care of the patient to ensure services are provided seamlessly throughout the continuum of care. Arranges and coordinates resources necessary to manage the patient's disease processes in the home environment and at alternate levels of care (SNF/LTAC/Rehab/Custodial Nursing Home) throughout the care continuum and adheres to the CMSA Standards of Practice for Case 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. This job description is a summary of the primary duties and responsibilities of the job and position.

It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at Ochsner's discretion.

Required
-Associates degree

Preferred
-Bachelor's degree in Nursing, additional degrees,business training experience and/or certifications may be combined to meet minimum qualifications.

Required
-6 years experience in managed care, utilization or quality management, regulatory compliance, medical management or other related MCO departments/functions with certification as a CCM. Experience with data capture in a Care Management software system, such as Case Trakker, CCMS, Amisys, and Facets. Experience with Microsoft Office software tools.

Required
-Registered Nurse in the state of Louisiana

Certification as a Case Manager (CCM) required within 2 years of hire

Required
-Three years experience in managed care, utilization or quality management, regulatory compliance, medical management or other related MCO departments/functions with BSN

• Must have computer skills and dexterity required for data entry and retrieval of patient information. Must be proficient with Windows-style applications and keyboard.
• Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals.
• Excellent knowledge of managed care, CMS, Medicaid and other regulatory standards/requirements. Knowledge and experience in using, community resources and other resources to facilitate the patient's care throughout the care continuum.
• Good organizational skills
• Strong written and verbal communication skills
• Strong time management skills and self directed
• Demonstrates Good Judgement

• Identifies patients with complex or catastrophic conditions who are at high risk and collaborates with members at the health care team, the patient and the patient's caregiver(s) to implement a coordinated treatment plan across the continuum.
• Utilizes the case management process to develop comprehensive cost-effective plans at care for patients in care management.
• Collaborates with the multidisciplinary team, PCP and other appropriate care providers to facilitate appropriate care and treatment of the patient
• Coordinates referrals…