RN Field Coordinator

50% - 70% Travel Position

Travel will be in Queens, New York Area

3 Months contract with a high possibility of going PERM

Job Description:

· Evaluates members for case management services and determines appropriate level of care coordination/ management services for member

· Completes a comprehensive assessment and develops a care plan utilizing clinical expertise to evaluate the members need for alternative services

· Acts as a primary case manager for members identified as Complex as defined by Case Management Program Description

· Develops and monitors members plan of care to include progress toward meeting established goals and self-management activities

· Interacts continuously with member family physician(s) and other providers utilizing clinical knowledge and expertise to determine medical history and current status.

· Assess the options for care including use of benefits and community resources to update the care plan

· Supervises and/or acts as a resource for non-clinical staff (i.e. Service Coordinators and Field Social Workers

· Act as liaison and member advocate between the member/family physician and facilities/agencies

· Maintains accurate records of case management activities in the Enterprise Medical Management Automation (EMMA) System using clinical guidelines

· Coordinates community resources with emphasis on medical behavioral and social services.

· Applies case management standards maintains HIPAA standards and confidentiality of protected health information and reports critical incidents and information regarding quality of care issues

· Ensures compliance with all state and federal regulations as well as Corporate guidelines in day-to-day activities

· Meets with clients in their homes work-sites physician?s or hospital to provide management of services

· Adapts to changes in policies procedures new techniques and additional responsibilities

· Participates with other Case Managers and Medical Directors in regular or special meetings such as Clinical rounds

· Travel to inpatient bedside member?s home provider?s office hospitals etc required with dependable car. May spend up to 70% of time traveling with exposure to inclement weather and normal road hazards.

· RN license Required

· Clear and active Drivers License / Own Vehicle

· 2+ years of experience in clinical acute care Required

· 1+ year of experience in current case management

· Other Managed care experience Preferred

· Prior utilization management experience preferred in some geographic regions

· Experience in care of the elderly is required in some geographic regions

· Experience in home health physicians office or public health

All your information will be kept confidential according to EEO guidelines.