PH Registered Nurse
Full Time
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Calibrated Healthcare is looking for experienced PHRN Nurses to join our team … if you are searching for career opportunities, company that has good culture and healthy environment plus a (temporary) work from home arrangement …. then join our team!!!
ESSENTIAL FUNCTIONS
- Under the general direction of the RN CM, responsible for the execution of care plan interventions for an assigned group of patients.
- Responsible for accurate and timely completion of the data collection processes for an assigned group of patients.
- Responsible for providing evidenced-based self-management strategies, health coaching, and health education to the assigned population.
- Responsible for updating the care plan based on care coordination activities for members open to case management.
- Conducts ongoing follow-up with the individual, family and/or family caregiver in the evaluation of care coordination activities
- Responsible for adherence to the policies and procedures for the Contact Center; to include, but not limited to, managing the outbound call queue to collect data for health risk assessments, coordinate care for care gap closures, or specialty referral tracking.
- Responsible for transition of care outreach, coordination, and information exchange per policies and procedures.
- Ensures compliance with desktop procedures for appropriate documentation
JOB SKILLS
- Core Competencies: Ethics and Values, Customer Focus, Action-Oriented, Learning on the Fly, Manage/Measure Work, Drive for Results, Priority Setting, Timely Decision-Making, Organizing, Functional and Technical Skills
- Demonstrated ability to work together across professions and individuals to improve health outcomes.
- Computer Proficiency (MS Word, MS Excel, MS Outlook, Video Conferencing)
- Capacity to interpret evidenced based guidelines (Interqual and/or Milliman criteria sets), health plan/client specific chronic care guidelines, and policies/procedures
- Knowledge of NCQA, DMHC, and state requirements for case management
REQUIREMENTS
- Bachelor degree in Nursing
- Active PHRN License
- Previous case management, utilization review, CPO working experience, health services experience is an advantageHealth insurance
Job Type: Full-time
Salary: Php25,000.00 – Php40,000.00 per month
Benefits:
- Health insurance
- Life insurance
Schedule:
- 8 hour shift
Experience:
- CPO Industry: 1 year (Preferred)
Language:
- English (Required)
License/Certification:
- PHRN License (Required)
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