Excellent employment opportunity!
CareMore is looking for dynamic individuals to join our team!
CareMore is a leading healthcare system specializing in providing a complete, pro-active health care experience to Senior Americans. CareMore strongly believes in our innovative and caring vision to lead the next generation of health care and we look for candidates that share in our passion.
As a leader in senior healthcare for over 20 years, our vision is to significantly improve the lives of Medicare recipients by employing a dedicated staff of professionals who are passionate about changing lives. When you join CareMore, we’ll give you every opportunity to make a real difference.
Be More with CareMore.
CASE MANAGEMENT NURSE EXTENDER
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Job Description:
The ESRD Program Nurse Extender is responsible for delivering and coordinating services for all ESRD members including but not limited to transplant related cases. The ESRD Program Nurse Extender works in collaboration with the ESRD Program Supervisor and lead clinician to ensure CareMore members receive proper care at dialysis facilities, outpatient nephrology clinics and hospital settings. The ESRD Program Nurse Extender, coordinates, monitors, and evaluates services to meet member’s health needs and to ensure appropriate use of clinical resources under the supervision of the ESRD Program Supervisor.
Responsibilities Include:
Essential duties and responsibilities include but are not limited to:
• Monitors the delivery of care across all markets for the identification of quality of care issues related to ESRD and transplant cases (ie: delayed in care, post complications and family/member dissatisfaction).
• Contact for assigned nephrology network for reporting of issues/concerns to ensure appropriate communication and management is executed (ie: Senior Medical Officer, Regional Medical Officer, Director of Case Management, Corporate Compliance/Risk Management and HIPPA Compliance Officer)
• Coordinates and authorizes access placement as requested by nephrologists..”
• Gathers and reviews medical records for surgical referral with Senior Medical Officers.
• Coordinates and communicates with nephrology office staff regarding initial access plan and dialysis center
• Based on industry standard metrics all CKD (Chronic Kidney Disease) are reviewed to ensure timely management of access for initial dialysis including, scheduling appointment with surgeon for pre-access evaluation as indicated.
• On on-going basis keeps all providers involved in member’s care updated on appointments, condition change and need for additional clinical support.
• Maintains access, admission and transplant history in CareMore’s database system.
• Maintains and research all vascular surgery/procedures requests for all members as directed by Senior Medical Officer.
• Requests and gathers necessary medical records as requested by Medical Director for all transplant candidates.
• Provides on-going monitoring and coordination of care for all pre-transplant, transplant and post-transplant candidates; including tertiary care work up and resource management for member and family.
• Observe all policies and procedures for use of time keeping system including attendance and tardiness.
• Interact with patients, physicians, staff, and outside facilities in ways that demonstrate caring and reflect CareMore’s mission and philosophy.
• Perform any additional / miscellaneous duties (not inclusive of job description) as requested by the management team within the scope of knowledge / ability.
Education and Experience:
•High school diploma, 2-3 years related experience in a managed care industry.
• Medical Assistant Certification preferred.
• Two years previous experience in Case Management Care Coordination in an HMO environment.
• Experience and proficient in HMO authorization process.
• Knowledge of end stage renal disease management.
• Knowledge of medical terminology, ICD9 and CPT codes.
Compensation/Benefits:
CareMore offers a comprehensive benefits package to include medical, dental, vision, life, long term disability, flexible spending accounts, 401(k), PTO, paid holidays and much more.
Are you interested in becoming part of our team? If so, we want to hear from you.
Be More today.
AA/EOE M/F/D/V
Watch how our CareMore Employees care more, in the video below.
