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Skills competency checklist-REQUIRED and must be uploaded during compliance checks
Elder Abuse training
HIPAA training
Infection prevention and control
OSHA compliance
Education/skills training received in the past 12 months. This includes copies of any training they may have received in the past 12 months.
Primary Responsibilities: Perform comprehensive assessment of high risk members. Collaborate with primary care providers to ensure the implementation of an individualized comprehensive care plan with specific interventions designed to engage the member. Address identify and continuously reassess cost-efficient appropriate levels of care. Put non medical support in place to ensure compliance with treatment plans (such as housing and transportation). Coordinate care transitions as needed. Coordinate with physicians social workers discharge planners and claims professionals in transitioning patient to appropriate level of care. Engage specialty resources as needed to achieve optimal resolution. Keep detailed records of clinical functional and fiscal outcomes during the management process. Identify opportunities for health promotion and illness prevention. Prevent adverse patient occurrences when possible and intervene quickly if prevention is not possible thereby minimizing poor as patient advocate by protecting privacy and confidentiality issues.
Qualifications: Associates or Bachelors Degree in Nursing or related field. Current unrestricted state Registered Nurse license. Ability to analyze complex medical information and make rational decisions. Case Management certificationFull Time