Job Search Results for HSE advisor

{"JobID":368058,"JobType":["Contract-to-perm"],"EmployerID":null,"Location":{"Latitude":-76.4829090909091,"Longitude":38.9821818181818,"Distance":null},"State":"Maryland","Zip":"21401","ReferenceID":"HSE-718650","PostedDate":"\/Date(1720718079000)\/","Description":"Insight Global is looking for a Case Manager (RN) to support a medical center in Annapolis, MD. The Case Manager works under the direction of the clinical director of care management, providing coordination of care for patients to support safe, seamless, timely transitions across the continuum. Utilizing a collaborative process, will identify (using quantitative and qualitative methods), assess, plan, implement and evaluate the options and services required to meet an individuals health and health related needs, including social- determinants that affect ones overall wellbeing. Promotes the right resources, at the right time and at the right level of care and is responsible for engaging and supporting patients that need care management services; is able to determine, using evidence-based guidelines, the correct initial and ongoing level of care for patients and is able to submit appropriate denial review for Medicare, Medicaid, and commercial insurers.Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Identifies and prioritizes patient in need of care management services, using a holistic approach inclusive of biopsychosocial, functional, cultural, spiritual, and financial factors; uses a multi-disciplinary approach to assess/plan for care needs.2. Identifies and implements strategies such as motivational interviewing to promote patient engagement, self-care, treatment adherence, and optimal levels of health and well-being.3. Utilizes evidenced based guidelines (such as InterQual or other agreed upon evidenced based guidelines) to promote quality care, decrease variation and mitigate waste. Verifies appropriate level of care; enters clinical review and authorized days in Epic; documents actions to avoid denied days; refers cases to Physician Advisor as appropriate.4. Manages observation stay patients assertively and ensures timely testing, treatment and conversion to inpatient status or discharge. 5. Develops and coordinates transition plans for patients transitioned to home with home health, community care coordination program, Hospice or Palliative care, home infusion and routine sub-acute and skilled post-acute providers; completes all necessary documentation and necessary handovers. Involves and prepares patients and families for transition from the ED, Peds, or Observation unit as indicated. 6. Maintains clear and concise documentation in each patient record to reflect physical and functional limitations, psychosocial characteristics, educational needs of patient \u0026 family, family/social support systems, financial, economic, and transition needs. Initiates referrals to disciplines as indicated.7. Participates in nursing unit and department clinical outcome projects as well as process improvement initiatives of care management. 8. Identifies potential or current patient situations which require referral to other members of the health care team such as infection control, risk management, or quality management. Assures plan of care is adjusted as appropriate and that follow-up occurs. Keep leadership abreast of potential issues.9. Utilizes all risk and predictive analytic tools such as the readmission risk tool. Applies tailored interventions to mitigate potential barriers or risk, prolonged unnecessary hospitalization and readmission prevention. 10. Maintains compliance with all regulatory standards (CMS, commercial insurers etc)*Must be non-smoker! (Candidate will be drug tested; includes nicotine)We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global\u0027s Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .","Title":"Case Manager (RN)","City":"Annapolis","ExpirationDate":null,"PriorityOrder":0,"Requirements":"Current licensure as a registered nurse by the Maryland Board of Nursing. BSN or ADN with equivalent experienceoBSN must be achieved within 5 years of start date in the role2+ years experience in a clinical setting, ambulatory or post-acute.","Skills":"Care coordination experience preferred.","Industry":"Case/Care Manager (Healthcare)","Country":"US","Division":"IGH","Office":null,"IsRemoteJob":false,"IsInternalJob":false,"ExtraValues":null,"__RecordIndex":0,"__OrdinalPosition":0,"__Timestamp":0,"Status":null,"ApplicantCount":0,"SubmittalCount":0,"ApplicationToHireRatio":0,"JobDuration":null,"SalaryHigh":30.0000,"SalaryLow":24.0000,"PayRateOvertime":0,"PayRateStraight":0,"Filled":0,"RemainingOpenings":0,"TotalOpenings":0,"Visa":null,"ClearanceType":null,"IsClearanceRequired":false,"IsHealthcare":false,"IsRemote":false,"EndClient":null,"JobCreatedDate":"\/Date(-62135578800000)\/","JobModifiedDate":"\/Date(-62135578800000)\/"}