RN Care Manager WellMed El Paso, TX - El Paso, Texas - 523681

The primary responsibility of the Care Team Manager RN is to identify, screen, track, monitor and coordinate the care of Health Plan members with multiple co-morbidities and/or psychosocial needs and develop a nursing plan of care. They will interact and collaborate with interdisciplinary care team, which includes physicians, case managers (i.e., UM inpatient case managers), referral coordinators, pharmacists, laboratory technologists, social workers, dietitians and other educators and nurses. The Care Team Manager RN also acts as an advocate for members and their families linking them to other members of the care team to help them gain knowledge of their disease process and to identify community resources for continued growth toward the maximum level of independence. The Care Team Manager RN will participate in interdisciplinary conferences to review clinical assessments, update care plans and determine follow-up frequency with the team.

***This position requires to work in the office and local (East El Paso area) travel into patients home as well as Telephonic follow up***

Essential Job Functions

Collaborates effectively with interdisciplinary team to establish an individualized plan of care for members. The interdisciplinary team includes physicians, case managers, referral coordinators, pharmacists, laboratory technologists, social workers, dieticians and other disease educators. Develops interventions to assist the member in meeting short and long term plan of care goals.
Provide assessments of physical and psycho-social needs in settings not limited to the PCP office, hospital, or member's home. Develops interventions and processes to assist the Health Plan member in meeting short and long term plan of care goals.
Coordinates and attends member visits with PCP and specialists as needed.
Manages assigned case load in an efficient and effective manner utilizing time management skills to facilitate the total work process directly monitoring assigned members and indirectly monitoring the team's LVN Telephonic Care Coordinator case load as well.
Provides constructive information to minimize problems and increase customer satisfaction.
Seeks ways to improve job efficiency and makes appropriate suggestions following the appropriate chain of command.
Performs all duties for internal and external customers in a professional and responsible manner having fewer than 2 complaints per year.
Enters timely and accurate data into designated care management applications as needed to communicate patient needs.
Adheres to organizational and departmental policies and procedures.
Takes on-call assignment as directed.
Solves problems by gathering and or reviewing facts and selecting the best solution from identified alternatives. Decision-making is usually based on prior practice or policy, with some interpretation. Must apply individual reasoning to the solution of problems, devising or modifying processes and writing procedures as necessary.
Maintains current knowledge of health plan benefits and provider network including inclusions and exclusions in contract terms.
With the assistance of the Managed Care/UM teams, guides physicians in their awareness of preferred contracts and providers and facilities.
Attends educational offering to keep abreast of change and comply with licensing requirements and assists in the growth and development of associates by sharing knowledge with others.
Participates in the development of appropriate QI processes, establishing and monitoring indicators.
Performs all other related duties as assigned

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