RN Case Manager I - H-E-B Wellness Primary Care

Click here to learn more! Healthcare, Plus. It's a goal and a promise. At H-E-B Wellness Primary Care, it's our goal to help everyone live the healthiest life possible. And it's our promise that H-E-B Wellness care will be better than Partners have ever experienced: accessible, convenient, engaging, and complete. Join us and be part of something special. Help us provide comprehensive services that include primary care, health coaching, physical medicine, care navigation, and more. As a Nurse Case Manager I, you'll work closely with physicians, social workers, and other medical / non-medical professionals to meet patient needs; you'll promote quality care that includes advocating proper use of available resources, and stay engaged so you can recognize the need for current / future care. Once you're eligible, you'll become an Owner in the company, so we're looking for commitment, hard work, and focus on quality and Customer service. 'Partner-owned' means our most important resources--People--drive the innovation, growth, and success that makes H-E-B The Greatest Retailing Company. Do you have a: HEART FOR PEOPLE... skills to collaborate cross-functionally to advocate for patients? HEAD FOR BUSINESS... a strong sense of how what you do affects our People? our success? PASSION FOR RESULTS... drive to improve standard care related to Partner health? We are looking for: - RN, with case management experience - CCM (preferred); interpersonal skills What is the work? Patient Care: - Identifies patient needs, current services, and available resources; connects services / resources to meet patient needs; develops a patient-focused case management plan - Provides case management for all inpatient/outpatient stays/procedures, ensuring continuity of care within the H-E-B Wellness clinical systems - Integrates BCBS Nurse program into clinical management to ensure continuity of care - Answers patient questions; makes referrals to medical treatment facilities; provides basic medical advice - Ensures patients receive medically appropriate services; ensures current / future care plans meet physical, social, and emotional needs of patients - Communicates care preferences; serves as advocate; verifies referrals meet needs / goals - Reviews medical charts; facilitates check-in / check-out processes - Documents patient case management plans and on-going activities - Identifies / addresses risk factors and obstacles to care - Works with social workers to obtain services, as needed - Works closely with Referral Coordinator to ensure lab and imaging results are received in a timely manner - Assists staff in interpreting medical reports / other medical information - Screens patients / Partner population for trending healthcare needs - May make onsite visits to specialty physician offices to evaluate whether they meet our requirements for partnership Compliance: - Explains Patient Care coordination program / process; reviews eligibility / authorization forms on behalf of H-E-B and Partners - Ensures ethical / legal issues are addressed; collaborates with other health care professionals to ensure patients receive appropriate levels of care - Applies knowledge of healthcare insurance reimbursement policies Training: - Educates on the case management process - Coordinates / provides educational presentations as requested - Trains support staff on basic care management tasks What is your background? - Bachelor's degree in nursing, public health, etc., or related field - Current, unrestricted State of Texas RN license - 3 years of experience in case management; experience in managed care (preferred) - Certified Case Manager (CCM) (preferred) - Experience working with electronic health records (preferred) - Psychology-related background (preferred) Do you have what it takes to be a fit as an H-E-B RN Case Manager I? - Advanced verbal / written communication skills - Strong interpersonal, negotiation, and conflict-resolution skills - Strong organization skills - Bilingual (English - Spanish)

Qualifications:

skills a plus - Ability to work independently - Ability to manage multiple priorities and shift focus between tasks Can you... - Function in a fast-paced clinic / office environment - Sit / stand for extended periods - Regularly lift up to 20 lbs - Work extended hours and / or rotating schedules 05-2019 MRN3232