Clinic Manager overseeing daily operations and patient care at Medcor's occupational health clinic. Collaborating with key stakeholders to ensure effective clinic workflows and logistics.
About the role
- Perform care management duties to assess and coordinate medical and supporting services across the continuum of care for complex/high acuity populations
- Develop and continuously assess personalized long-term care plans/service plans and collaborate with care management team
- Evaluate service needs of complex or high-risk members and recommend plans for best outcomes
- Coordinate and manage between members/families/caregivers and provider teams to ensure person-centered care
- Monitor member status, changes in condition, progress toward goals, and revise plans as necessary
- Review member data, referrals, and intake assessments to identify trends and develop appropriate care plans
- Collaborate with healthcare providers to facilitate services/treatments and revise care plans
- Collect, document, and maintain member information and care management activities for compliance
- Provide education to members and families/caregivers on disease processes, care options, referrals, and benefits
- Act as liaison and member advocate between member/family, physicians, and facilities/agencies
- Educate on and coordinate community resources and coordinate service authorizations (meals, housing, transportation, ADLs, etc.)
- May perform home/site visits (e.g., monthly) to assess needs and collaborate with resources
- Partner with leadership to improve quality of care and service delivery; may precept and coach clinical new hires
- Engage in onboarding, competency checkpoints, coaching, and shadowing for new hires/preceptees
Requirements
- Graduate from an Accredited School of Nursing or a Bachelor's degree
- 4–6 years of related experience (minimum 4 years)
- Bachelor's degree in Nursing preferred
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required
- For Superior Health Plan: Resource Utilization Group (RUG) certification must be obtained within 90 days of hire
- Clinical Registered Nurse experience in Acute Care settings (Critical Care, ICU, PACU, Public Health, Neurology, Emergency Room, Military or Veteran Hospitals, Adult Home Health, Cardiac ICU, Internal Medicine, LTC, SNF, Triage Nursing, or Nursing Rehab) preferred
- Experience in direct clinical nursing phone queue environment to assess and manage member needs via telephone
- Strong clinical assessment and critical thinking skills
- Clinical knowledge to determine overall health, treatment needs and appropriate level of care for complex medical conditions
- Ability to navigate multiple databases, screens, Microsoft Office applications and use multiple communication methods (phone queue, MS Teams, email, video conferencing)
- Ability to perform home and/or site visits as required
- Must reside in Texas for occasional training and meetings in a Superior Health Plan or Centene office
- Availability Monday - Friday: 8:00am - 5:00pm (CST)
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
- potential additional incentives and total compensation components
Job title
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