Case Manager - RN - Astrana Health
Monterey Park, CA 91754
About the Job
Description
As an RN Clinical Consultant, you play a pivotal role in ensuring the provision of high-quality care for enrollees within ECM Health Risk Assessments. You are entrusted with the critical task of assessing and determining the appropriate management of member care needs, either through the guidance of ECM Lead Care Managers or through your direct intervention and recommendation implementation in their Care Plans. Your expertise contributes significantly to the development of patient-centered care plans, fostering comprehensive approaches to healthcare that address acute conditions, chronic diseases, and medication management.
Key Responsibilities
- Clinical Oversight and Consultation: Provide clinical oversight of ECM Health Risk Assessments, participating in the development and approval of patient-centered care plans, and actively consulting with Care Managers to review medical summaries, discharge orders, and appointment outcomes.
- Health Education and Outreach: Mentor and guide Lead Care Managers on how to offer health care education, particularly for acute health conditions and chronic disease management, while engaging with vulnerable populations through multidisciplinary meetings.
- Data-Driven Interventions: Utilize data to evaluate outcomes from targeted interventions for a designated patient cohort, assisting in the development and adjustment of care plans based on analysis and insights derived from this data.
- Program Expansion and Collaboration: Collaborate in expanding programming to address Social Determinants of Health (SDoH) and enhance connections to community-based organizations, dedicating focused time to program development and refinement.
- Multidisciplinary Collaboration: Lead and collaborate with a case management team and community health workers to ensure client/patient-centered care aligns with established Care Plans and health goals. Primary care providers and specialists will be involved in collaboration if needed.
- Regional Engagement and Coordination: Assist lead care managers with transitions of care ensuring seamless coordination with hospitals, behavioral health clinicians, primary care physicians, and other relevant providers to prevent readmissions and support transitions in care. Collaborate with ECM Specialist to address ADT alerts and post discharge coordination of care.
- Quality Improvement and Compliance: Engage in quality improvement efforts, including chart reviews, audits, case conferences, and implementation of preventive care and engagement activities to continuously enhance the delivery of care.
- Onboarding and Training: Onboarding new case managers and providing guidance and refresher training to existing staff
- Training Guides: Build on Library of training materials for staff using: Power point, Vizio. Whimsical, Canva. etc
Skills, Knowledge and Expertise
- Valid Registered Nurse (RN) license in California
- Strong interpersonal skills and clinical problem-solving abilities.
- Can think outside the box
- Can work well independently
- Can work well as a team
- Computer skills, including: Teams, Excel and filters, email communication and data summarization in spreadsheets.
Who We Are
Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.
Our platform currently empowers over 12,000 physicians to provide care for over 1.3 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
Our Values:
Our platform currently empowers over 12,000 physicians to provide care for over 1.3 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
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Source : Astrana Health