The Outpatient Case Manager is responsible for patient triage, care planning and follow up.
1. Adheres to and supports the mission, purpose, philosophy, objectives, policies, and procedures of Tenet Physician Resources.
2. Adheres to the Tenet HIPAA Compliance Plan and the Privacy Standards Confidentiality Agreement.
3. Demonstrates support for the Tenet Physician Resources Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to the federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner.
4. Assists patients with chronic diseases in order to achieve improved health outcomes and enhance patient's healthcare experience and lower healthcare costs.
5. Advocates with community resources for additional services that are not covered by the patients insurance plan or if the patient has special needs
6. Promotes behavior change towards compliance with provider-directed treatment plans.
7. Engages patients and family members on self-management, setting short and long term goals.
8. Identifies gaps or barriers to care by working with the patients PCP care team as needed.
9. Maintains chart documentation to ensure all information about visit is completed and documented correctly.
1. Completion of an accredited Nursing Program
2. Current State RN Nursing License, Current CPR Certification
3. Minimum of five years’ experience in a case manager role
4. Basic understanding of medical terminology
5. Knowledge of medical office processes
6. Understanding of documentation required for physician office visits
7. Knowledge of the purposes, organization, and policies of the local community's health system sufficient to interact with the other health care providers
8. Knowledge of the policies and procedures of a clinic sufficient to provide effective patient care
9. Must have good understanding of industry standards around disease management such as NCQA
10.Strong medical knowledge and competence in chronic disease pathophysiology, polypharmacy, clinical assessment, and patient/family education
11.Demonstrated ability to problem solve and manager professional relationships
Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.