Atlantic Health System is seeking a full-time Nurse Care Manager (RN) for the Atlantic MSO at the Corporate office in Morristown to work 9:00am - 5:00pm.
Be the care coordination interface for our Optimus ACO Cigna population.
Access reports from payer portals related to high risk patients, frequent ER utilizers, and quality gaps in care opportunities and interface with Optimus practice clinical coordinators to perform outreach to patients.
Work closely with practices to ensure transitions of care activities occur after hospital discharge.
Performs care coordination for high-risk patients to ensure continuity of care and quality health-care delivery across the care continuum.
Work with practices to engage high risk patients into payer case management and disease management programs.
Utilizes established clinical pathways to facilitate comprehensive and consistent chronic disease specific condition education.
Utilizes payer reports and evidence-based risk-stratification tools to pro-actively assess chronically-ill population, identify patients at risk for disease-related sequelae and deliver patient-centered evidence-based interventions to prevent future progression or exacerbation of illness.
During exacerbation, intervenes at the earliest opportunity through multidisciplinary collaboration with all members of the care team, including patient and identified care-partner to return the patient safely to optimal level of health/function in an optimal setting.
Identifies opportunities for health promotion and disease prevention.
Identifies Social/Behavioral Health needs which impacts patient's outcomes and appropriately refers to Social Work team member.
Assess/Refer patients to available community support services as deemed necessary.
Collaborates with multidisciplinary team to develop innovative strategies addressing the needs of the population.
High School Diploma or GED required
Minimum of 5 years of clinical experience as a Registered Professional Nurse.
Current NJ Registered Professional Nursing license required.
Current PA and NY Nursing license a plus.
CCM certification preferred.
Community health experience and knowledge of community health-care resources preferred.
Strong clinical, interpersonal, analytical, priority setting, problem solving, and organizational skills.
Ability to work with minimum direct supervision.
Ability to navigate EHR and data bases with demonstrated ability for electronic clinical documentation.
Clear and accurate verbal, telephonic, and written communication skills.
Atlantic Health System aims to deliver the highest quality, safety and care combined the best experience for our patients and their families. We are confident that you will find success within Atlantic Health System, which has been named for the 14th year in a row to Fortune's 'Top 100 Best U.S. Companies to Work For' list. We believe you will find that our culture of collaboration and care exemplifies the value we place on our patients, their families and our employees.
Atlantic Health System, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status.