serp_jobs.breadcrumb.workplace_remote Case manager serp_jobs.h1.location_city

Job Description

Job Description

Summary

Responsible for providing case management services and support to improve health outcomes via a coordinated approach. The Case Manager works in collaboration and continuous partnership with patients and their family members, as well as pcp, specialists, clinic, hospital, and post-acute partners, along with community resources, to achieve the desired outcomes. Using a defined process to identify patients / members at risk for poor outcomes, the Case Manager establishes care plans and goals, and coordinates care and services throughout the continuum of care with the goal of maximizing member health and well-being, improving adherence to health programs, and reducing health care costs. The Case Manager must be highly collaborative with strong customer service skills and be able to demonstrate the ability to actively engage patients and providers in positive relationships. Must also be able to demonstrate the knowledge and skills necessary to provide care management services appropriate to the member being served.

Reports to : Director, Health Services

Location : Houston, TX area; will consider remote deployment on a case by case basis

Education

Education : Registered Nurse (RN)

LICENSES / CERTIFICATIONS :

Registered Nurse (RN) with active license in the state of Texas or Compact state.

Certification in Case Management preferred (CCM or ACM)

EXPERIENCE :

• Minimum 2 years in case management or care coordination required; chronic disease management or population health preferred
• Managed care experience preferred
• Strong ability to demonstrate knowledge of ACO initiatives and care management processes
• Understanding of NCQA and CMS care management guidelines preferred
• Experience working in interdisciplinary teams
• Computer proficiency required
• Strong oral and written communication skills required
• Effective oral and written communication skill
• Some travel in the Houston metro area may be required
• Remote deployment will be considered

SKILLS

RESPONSIBILITIES

TECHNICAL SKILLS

About Apex Health Solutions

Apex Health Solutions powers payers and providers choosing to engage in value-based risk contracting. Apex’s unique solutions create alignment between payers and providers, generating unparalleled value. Combined with Apex’s experienced and successful industry leadership, our focal point remains on improvement in patient quality, satisfaction and overall cost of care.