RN Program Consultant, Asthma Management

Ann & Robert H. Lurie Childrens Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence kids and their families are at the center of all we do. Ann & Robert H. Lurie Childrens Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.

General Summary:

Ensures the smooth daily operation of Disease Management (DM) programs for the Lurie Childrens Health Partners Clinically Integrated Network (LCHPCIN) by providing administrative support clinical guidance and ensuring contract compliance. This position shall report to the Director of Operations of the addition to general administrative functions this position is responsible for ensuring ongoing monitoring and reporting of compliance with contractual requirements for the Disease Management program monitoring of compliance of subcontractors with contractual requirements communication and coordination with the care coordination staff management and escalation of clinical matters to the Medical Director and tracking of any Corrective Action Plans required by health plans.

This position will receive initial and ongoing training in DM program specifics. They also receive ongoing user training in the processing of case management referrals and the use of both electronic medical record and DM tracking systems.

Essential Job Functions:

• Performs Disease Management functions with application of approved review criteria guidelines and processes (e.g. care plans goal setting and patient outreach).

• Ensures communication regarding Disease Management is provided to patients and providers in a timely manner and in compliance with contractual agreements.

• Provides coordination of daily DM functions and operations as assigned.

• Provides practitioners with written information about the DM program including instructions on how to access and use the programs as well as information about how patients are managed within the program.

• Responsible for ensuring monthly reports are submitted in a timely manner to Health Plans in the accepted format as designated by the Health Plans.

• Provides support to other Disease Management staff members.

• Under the supervision of the Medical Director communicates the clinical component for DM functions.

• Provide necessary reporting to the Board and the Medical Management & Credentialing Committee.

• Implements corrective action plans related to disease management as necessary.

• Develops and implements a tracking system for all contractual and sub-contractual requirements. System shall include assignment of responsible party specific service level agreements documentation and attestation requirements frequency of reporting and escalation process.

• Ensures compliance with protection of PHI (Protected Health Information) by CIN staff as required by HIPAA (Health Information Portability and Protection Act) and reports any violations to the Director of Operations and the CIN Compliance Officer.

• Ensures the timely submission of all required reports to the Executive Director Medical Director Director of Operations and health plans.

• Tracks and reports on all contractual and sub-contractual requirements and any Corrective Action Plan resulting from noncompliance.

• Performs job functions adhering to service principles with customer service focus of innovation service excellence and teamwork to provide the highest quality care and service to our patients families co-workers and others.

• Other job functions as assigned.

Knowledge Skills and Abilities:

• BSN or MHA or its equivalent preferred.

• Posses an IL RN License active and in good standing.

• Minimum of 2 years of disease management experience or related health plan program management required.

• Strong project document and database management and word processing skills.

• Strong organizational and analytical skills with the ability to prioritize competing demands.

• Strong written and verbal communication skills.

• Demonstrated knowledge of Microsoft Office Suite (Word Excel and PowerPoint).

• Access or other database management experience required.

Education

Pay Range

At Lurie Childrens we are committed to competitive and fair compensation aligned with market rates and internal equity reflecting individual contributions experience and expertise. The pay range for this job indicates minimum and maximum targets for the position. Ranges are regularly reviewed to stay aligned with market conditions.In addition to base salary Lurie Childrens offer a comprehensive rewards package that may include differentials for some hourly employees leadership incentivesfor select roles health and retirement benefits and wellbeing programs. For more details on other compensation consult your recruiter or click the followinglink to learn more about our benefits.

Benefit Statement

For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes:

Medical dental and vision insurance

Employer paid group term life and disability

Employer contribution toward Health Savings Account

Flexible Spending Accounts

Paid Time Off (PTO) Paid Holidays and Paid Parental Leave

403(b) with a 5% employer match

Various voluntary benefits:

• Supplemental Life AD&D and Disability

• Critical Illness Accident and Hospital Indemnity coverage

• Tuition assistance

• Student loan servicing and support

• Adoption benefits

• Backup Childcare and Eldercare

• Employee Assistance Program and other specialized behavioral health services and resources for employees and family members

• Discount on services at Lurie Childrens facilities

• Discount purchasing program

Theres a Place for You with Us

At Lurie Childrens we embrace and celebrate building a team with a variety of backgrounds skills and viewpoints recognizing that different life experiences strengthen our workplace and the care we provide to the Chicago community and beyond. We treat everyone fairly appreciate differences and make meaningful connections that foster belonging. This is a place where you can be your best so we can give our best to the patients and families who trust us with their care.

Lurie Childrens and its affiliatesare equal employment opportunity employers. All qualified applicants will receive consideration for employment without regard to race color sex sexual orientation gender identity or expression religion national origin ancestry age disability marital status pregnancy protected veteran status order of protection status protected genetic information or any other characteristic protected by law.

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