Care Management Coordinator RN
Facility: Maryvale Campus
Department: Care Management
Schedule: Regular - Full Time 36 Hours Per Week
Under the direction of the Manager Care Management, the Care Management RN Coordinator is accountable for identifying, stratifying, and addressing the needs of high risk populations. The Care Management RN Coordinator will be responsible for establishing and managing populations of high risk and other assigned populations in a manner that aligns with the regulations of the Center for Medicare and Medicaid Services (CMS) and the Arizona Health Care Cost Containment System (AHCCCS).
Requires an Bachelor's degree in Nursing.
Must have a minimum of three (3) years of acute clinical experience as an RN that demonstrates an understanding of the required knowledge, skills, and abilities.
Prefer prior experience in ambulatory nursing and/or hospital case management or equivalent.
Must possess a current, valid AZ RN license; temporary AZ RN license; or valid compact RN licensure for current state of practice.
Must also be in good standing with the issuing Board of Nursing. Specialty certification in utilization or case management must be obtained within 30 months of hire.
Knowledge, Skills & Abilities:
- Requires a proficiency in clinical criteria, evidence-based practice, regulatory compliance, reimbursement sources, and the health care delivery system.
- Must maintain a fundamental understanding of CMS regulations transitions of care.
- Must maintain a current knowledge in best practices and evidence-based research involving population disease management and wellness.
- Must be able to demonstrate knowledge of chronic disease states, preventative and wellness management practices and pathways, MIHS policy and procedures, and regulatory standards ensuring high quality and safe standards of care.
- Must exhibit competency in Microsoft Office software programs and other software systems once trained.
- Required to possess analytic skills to support data and trend evaluation.
- Must be a self-starter, demonstrate self-direction and work independently with minimal supervision.
- Expected to work in a fast-paced setting.
- Must demonstrate professionalism, team work, critical thinking skills and serve as a professional role model.
- Essential to possess excellent customer service and phone skills with the ability to communicate well, build rapport and collaborate with patients, internal and external clients in order to meet quality outcome goals.
- May be expected to assist other Care Coordinator RNs in the hospital.
- Has valid driver's license and driving record showing no restrictions that would impede ability to travel by automobile.
- Demonstrated computer literacy required with basic to intermediate knowledge of Microsoft Office applications including Word, Excel and PowerPoint.
- Experience with databases is preferred.
- Must be able to read, write and speak effectively in English.
- Bilingual Spanish speaking is preferred.