RN Group Lead, CCM-Louisiana- req6824

RN Group Lead, CCM-Louisiana- req6824
Schedule: Monday through Friday depending on business needs, between operating hours of 7am to 9pm local time with possible rotating Saturdays
Basic Purpose:
The primary purpose of this position is to provide telephonic Chronic Care Management services as an extension of the clinical staff of physician practices and manages a caseload of patients with 2 or more chronic conditions (50% of the time), and handles the clinical 1st level escalations from an assigned team of CCM Reps. The role provides a range of care coordination services, including ongoing health interviews, coordination with family members and other caregivers, and working with community services to ensure access to care.
Duties and Responsibilities:
50% of time, handles the escalations that arise from the assigned team of approximately 20 CCM Reps, in situations that require further medical expertise, insight and knowledge in order to assess the needs and provide quality care
Helps to coach CCM Reps on quality and clinical issues and provides information feedback and coaching
May serve as a back-up to assigned CCM Reps, to provide continuity of care and relationship building with assigned patients
Conducts a regularly scheduled monthly 20 minute outreach calls with assigned patients designated to Chronic Care Management. Phone calls may include gathering health status, medication use, reviews orders from the referring physician, and ensuring through this investigative interview, that there is a record of the patient's chronic health condition(s).
Provides clinical judgment outside of provided script when appropriate, based upon the signs and symptoms disclosed by the patient.
Will utilize a proprietary application and systems to view the patient's plan of care, and follow supplied scripts to guide the monthly interviews, gaining participation from a member in a variety of programs and assisting in a variety of medical related support tasks under the general supervision of the referring physician.
Handles all inquiries via phone, email and other electronic communication in a timely manner to effectively provide a high level of customer satisfaction both internally and externally
Captures information gathered during telephone calls with patient within an online system in a timely and accurate manner. Maintains accurate, complete, and legible records.
Provides resolution on routine to moderate issues and is responsible for providing a professional response back to all internal/external requestors. Identifies situations were escalation may be required to a LPN or RN for resolution.
Uses established protocols for reporting and documenting client issues or concerns around access to care, transitions of care and care coordination.
Escalation severe issues that fall outside of typically duties to appropriate parties for resolution. Adheres to department quality and responsiveness standards.
Responds to the needs and requests of clients and ExamOne management and staff in a professional and expedient manner.
Understands and complies with federal, state and local laws, including but not limited to HIPAA and OSHA
Observes all compliance policies and safety policies and procedures as outlined in the ExamOne Safety Manual or safety matters included in other special training.
Proactively manages an assigned outbound call volume, and successfully controls the conversation and flow of the interview to meet time requirements.
Successfully builds relationships with patients in an assigned territory.
Follows standard operating procedures to perform daily tasks.
Ability to monitor and meet individual monthly scorecard metrics.
Supervisor Exercised: N/A
Education Required:
LPN or Registered Nurse
Work Experience:
Experience in medical terminology or health industry
2 years' experience performing as a nurse in a variety of environments including telephonic care support
Past experience working in a remote or at home environment desirable
1+ years of experience providing care telephonically via face to face highly desirable
Other: Minimum Skills Required
Excellent oral communication skills, and capable of interfacing with patients, peers, and management staff in a clear and professional manner.
Demonstrated ability to coordinate care, show empathy and deep listening via the phone
Precise time management skills
Ability to adapt to change in the environment
Good organization and follow-through skills
Ability to work within structured, goal oriented environment.
Good problem-solving skills and independent decision-making abilities.
Work in a fast paced environment handling multiple tasks (including working with phone & PC simultaneously).
Work independently with little supervision.
Detail-oriented and accurate with names/numbers.
Ability to perform accurate data entry of medical information
Good organization and follow-through skills.
Demonstrate Integrity and a commitment to company values.
Demonstrated knowledge of Microsoft Office applications (Outlook, Word, Excel)
Ability to influence and solicit sensitive information from patients via the phone and increase their comfort and participation in CCM program
Physical and Mental Requirements:
Able to sit for extended amount of time talking over the phone and typing information into a computer system.
While performing the duties of this job, the employee is regularly required to communicate in person and on the telephone.
The employee is frequently required to use hands to finger, handle, or feel in order to operate computer keyboard, office equipment and other essential tasks.
The employee is frequently required to sit, stand, walk, bend, stoop, crouch and reach with hands and arms.
This position infrequently lifts carries or otherwise moves and positions objects weighing up to 10 pounds.
All requirements are subject to possible modifications to reasonably accommodate individuals with disabilities. Quest Diagnostics is an Equal Opportunity Employer: Women / Minorities / Veterans / Disabled / Sexual Orientation / Gender Identity.

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