Apply on Employer Site

WVU Medicine · 22 hours ago

Peak Focused Disease Management Coordinator. Population Health

Core, WV

Full-time

Hybrid

Senior Level

5+ years exp

WVU Medicine is a healthcare provider that is looking for a Disease Management Coordinator to collaborate with patients and primary care providers. The role involves coordinating, monitoring, and evaluating healthcare services to optimize patient health status.

Health CareHospitalMedical

Responsibilities

Ambulatory Utilization Management, Financial Management and Quality Screening for assigned patients

Identifies the targeted population and risk stratifies all patients to prioritize needs and direct interventions

Communicates and collaborates with inpatient and outpatient case management to implement the discharge plan and coordinate a safe transition to the next level of care

Works in collaboration with physicians/providers, patients, and their families to ensure safe and efficient transitions of care

Works collaboratively with patients to design an individualized plan of care that ensures coordination of services by the healthcare team

Collaborates with available social services for appropriate resource and financial management which may include, but is not limited to financial assistance coordination/referrals, entitlement program coordination/referrals, patient benefit coordination, assessment for appropriate usage of Health Care Resources/clinical cost efficiency

Coordinates/facilitates patient progression throughout the continuum, Transitional Planning, Advocacy and Education:

Clinical performance improvement, outcome management and quality activities

Uses data to drive decisions and plan/implement performance improvement strategies for assigned patients, including fiscal, clinical and patient satisfaction data

Implements clinical interventions based on risk stratification and evidence-based clinical guideline adherence and promotes best practice by initiating/adjusting therapies as directed by the practitioner and providing appropriate follow-up monitoring as needed

Coordinates appropriate laboratory and diagnostic testing

Continuously evaluates laboratory results, diagnostic tests, utilization patterns and other metrics to monitor quality and efficiency results for assigned population

Participates in development, implementation, evaluation and revision of clinical pathways and other tools

Educates the multidisciplinary team and physicians about clinical pathways/protocols and managed care principles

Works with leadership to design, implement, and evaluate a centralized care model that optimizes value. Works with leadership to continuously evaluate process, identify problems, and propose process improvement strategies

Monitors clinical and financial indicators on an ongoing basis and takes action to achieve continuous improvement in both areas

Qualification

Registered Nurse licenseClinical experienceBasic Life Support certificationCare coordination experienceIndependent judgmentInterpersonal communication skillsNegotiation skillsFlexibilityAdaptability

Required

Associate's Degree in Nursing AND Seven (7) years clinical experience in a healthcare setting OR Bachelor's Degree in Nursing AND Five (5) years clinical experience in a healthcare setting

Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC)

State criminal background check and Federal (if applicable), as required for regulated areas

Obtain certification in Basic Life Support within 30 days of hire date

Possesses excellent interpersonal communication and negotiation skills in interactions with patients, families, physicians, and health care team colleagues

Ability to work with people of all social, economic, and cultural backgrounds and be flexible, open minded, and adaptable to change

Capable of independent judgment and action regarding psychosocial needs of patients