Personal Health Nurse

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

📋 Description

• Oversee accounts utilizing the 4-Prong approach, ensuring expected billable hours are met while employing Conifer Value Based Care tools in accordance with established protocols.

• Accurately document Status, Sub-status, Patient Severity, and Medical Management Acuity.

• Review the daily schedule for new episodes and due tasks, prioritizing activities effectively.

• Conduct Personal Health Management assessments based on clinical claim charts, member discussions, and physician assessment and treatment plans.

• Identify and document member goals, actively engaging members in the Personal Health Management process.

• Create and maintain individualized plans of care that include timeframes, expected outcomes, interventions, and member goals.

• Ensure follow-through on interventions and document outcomes in the Current Clinical Status section of the care plan.

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

• Collaborate with members and PCPs to formulate individualized plans of care.

• Close episodes as necessary, including assessing impactability.

• Liaise with clients and CCCS client managers regarding the medical management of designated clients.

• Execute Personal Health Management and certain Utilization Management functions.

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

⛳️ Requirements

• Bachelor’s degree in a health-related field is required.

• Three to five years of varied clinical experience are necessary.

• Five years of experience in Utilization Management/Case Management is preferred.

• A valid RN (Registered Nurse) license is required.

• Must hold a current active professional license in the state of residence.

• Eligibility for unrestricted professional licenses across all states is necessary.

• CCM certification is preferred.

• Comprehensive understanding of holistic medical management and client needs.

• Familiarity with legislative acts such as the ADA is essential.

• Proficiency in Microsoft Word and email, including attachments.

• Exceptional verbal and written professional communication skills.

• Ability to analyze and resolve complex issues effectively.

• General knowledge of cost containment and its relationship to medical management.

• Strong organizational, prioritization, and time management abilities.

• Capability and willingness to work independently as well as collaboratively within a team.

• Ability to work seated, utilize a computer, and respond to telephone inquiries.

• Capability to travel and navigate through hospital-based departments, including environments in the Emergency Department.

• Required vaccinations and screenings may need to be obtained and confirmed prior to employment, as applicable and permitted by law.

🏝️ 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.

• 10 paid holidays each year.

• Health savings accounts.

• Healthcare and dependent flexible spending accounts.

• Employee Assistance program.

• Employee discount program.

• Voluntary benefits including pet insurance, legal insurance, accident and critical illness insurance, long-term care, elder & childcare support, AD&D, and auto & home insurance.

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

• Potential sign-on and relocation bonuses for management level positions.

• Competitive benefits package.

• Resources, incentives, and leadership support for career development.