Personal Health Nurse

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee accounts utilizing the 4-Prong strategy and Conifer Value Based Care tools (CCOO).

• Achieve the required billable hours and document Status, Sub-status, Patient Severity, and Medical Management Acuity.

• Review the daily schedule for new cases and pending tasks, prioritizing accordingly.

• Conduct Personal Health Management evaluations using clinical claim charts, discussions with members, and assessments and treatment plans from physicians.

• Identify and record member objectives.

• Actively involve members in the Personal Health Management process.

• Create personalized care plans that include timeframes, anticipated outcomes, interventions, and member objectives.

• Implement interventions and document results in the Current Clinical Status section.

• Collaborate with PCPs and treating physicians in the Personal Health Management process.

• Work together with members and PCPs to create tailored care plans.

• Close episodes as necessary, including assessing impactability.

• Execute Personal Health Management and certain Utilization Management tasks.

• Interface with clients and CCCS client managers.

• Provide medical management services for assigned clients.

• Travel approximately 5–30% based on the assigned client.

⛳️ Requirements

• Bachelor’s degree in a health-related discipline.

• Preferred five (5) years of experience in UM/CM.

• Required three to five (3-5) years of diverse clinical experience.

• RN (Registered Nurse) license is mandatory.

• Current active professional license in the state of residence is essential.

• Eligibility for unrestricted professional licenses across all states.

• CCM certification is preferred.

• Knowledge of CCCS's holistic approach to medical management.

• Awareness of the client’s perspectives and requirements.

• Familiarity with legislative acts, including the ADA.

• Proficiency in Word.

• Ability to use email and attachments competently.

• Outstanding verbal and written communication skills.

• Capacity to analyze and resolve intricate problems.

• General comprehension of cost containment and its connection to medical management.

• Excellent organizational, prioritization, and time management skills.

• Capability and willingness to work both independently and as part of a team.

• Required vaccinations and screenings prior to employment, as applicable and permitted by law.

• Ability to work while seated, use a computer, and answer the telephone.

• Willingness to travel and navigate hospital departments across extensive campus settings, including Emergency Department environments.

🏝️ Benefits

• Medical, dental, vision, disability, life, and business travel insurance.

• Paid time off (vacation & sick leave) – minimum of 12 days annually.

• 401k plan with up to 6% employer matching.

• Ten paid holidays each year.

• Health savings accounts.

• Flexible spending accounts for healthcare and dependents.

• Employee Assistance program.

• Employee discount program.

• Optional pet insurance.

• Optional legal insurance.

• Optional accident and critical illness insurance.

• Optional long-term care insurance.

• Optional elder & childcare benefits.

• Optional AD&D insurance.

• Optional auto & home insurance.

• Paid leave in Colorado in accordance with the Healthy Families and Workplaces Act.

• Sign-on and relocation bonuses may be available for management-level positions.