RN Outpatient Care Manager - Covington-FT

About the role

We're seeking a Manager to oversee complex and catastrophic patients in our network. This role is embedded in the Primary Care Practice and plays a key part in the Patient Centered Medical Home. You'll coordinate care among various healthcare providers, community services, and payors to ensure seamless care throughout the continuum.

Responsibilities

• Utilize the Case Management process to assess health care needs and develop comprehensive treatment plans.
• Collaborate with the PCP team and other providers to implement and modify treatment plans based on patient needs.
• Negotiate and coordinate services for patients, ensuring their care is aligned with goals and objectives.
• Monitor and evaluate the effectiveness of the treatment plan, making adjustments as necessary.
• Coordinate resources necessary for managing patients' disease processes in both home and alternative care settings.
• Adhere to CMSA Standards of Practice for Case Management.

Requirements

• Associates degree in Nursing or related field, with 6 years of experience in managed care, utilization or quality management, regulatory compliance, medical management or other related MCO departments/functions.
• Certification as a CCM within 2 years of hire.
• Experience with data capture in a Care Management software system, proficiency with Windows-style applications, and strong communication skills.

Qualifications

• Bachelor's degree in Nursing preferred.
• Registered Nurse in the state of Louisiana.
• Knowledge of managed care, CMS, Medicaid, and other regulatory standards/requirements.
• Experience identifying quality issues and submitting them to the quality department.

Skills

• Effective verbal and written communication skills.
• Good organizational skills.
• Strong time management skills.
• Good judgment.

Benefits

At Ochsner, we offer competitive benefits to support your well-being. These may include health insurance, retirement plans, paid time off, and more. Details will be provided upon interview.

Pay

Competitive compensation package tailored to your experience and qualifications.

Schedule

Flexible schedule to accommodate your needs and the demands of the role.