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| Clinical Quality Manager PA Open (J#45443) Title: Clinical Quality Manager Company: The Judge Group Inc Position Summary (Purpose of job):The goal of the Case Manager is to ensure delivery of optimal care while promoting fiscal responsibility. Participates in the coordination and direction of care for members with high cost/high risk conditions. The Case Manager will address the issues of health assessment and appropriate intervention. In addition, evaluates available resources, plans, and implements necessary services and monitor outcomes and collaborates with other members of the health care team. This role may be hospital-based, community-based, long-term facility-based or telephonic. Key Responsibilities (List the top five to seven essential responsibilities in priority order):- Review and identify high cost/high risk member referrals- Complete physical, mental, social and financial assessments - Create an individual plan of care in collaboration with member and health care team which ensures safe, quality care at the most appropriate, cost effective level- Assist in implementing plan of care - Evaluation of care plan, modify as needed- mCommunicate closely with member, support system and physician(s) Minimum Job Qualifications: Education/Training - - Registered Nurse from an accredited nursing program - CCM certified or eligible within two years Business Experience - - Active, unrestricted nursing license- 5 years clinical experience, preferably acute care- 3 years case management experience- Computer proficiency Specialized Knowledge/Skills -- Thorough knowledge of case management including disease management- Understanding of family and group dynamics- Familiarity with change behavior techniques- Knowledge of resources in the community, laws, regulations and policies which govern case management- Skill in establishing rapport with members, families, and local resources (medical, social, civic, legal and religious organizations)- Ability to communicate and execute work effectively- Preferably a member of the local community- Preferably bi-lingual All candidates that are interested in this position or similar positions send an email to or you can reach Nicole directly at 888-229-7162 Ext. 1519Position Summary (Purpose of job):The goal of the Case Manager is to ensure delivery of optimal care while promoting fiscal responsibility. Participates in the coordination and direction of care for members with high cost/hig More... | |||
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