The Telephonic Case Manager provides telephonic outreach, disease and/or case management, education and support to plan Enrollees to support healthy lifestyle choices & to reduce long term effects of chronic illnesses.
APS Healthcare provides health services to our member populations, with the goal of improving the health of those we serve. We have an exciting opportunity for a Telephonic Case Manager - RN based in our Harrisburg, PA office. The ACCESS Plus Program is a primary care case management (PCCM) system that features a medical home a designated Primary Care Provider (PCP) for each ACCESS Plus Enrollee in the 42 county ACCESS Plus area. ACCESS Plus is an enhanced PCCM program, delivering greater value to Enrollees, Providers, and the DPW. These enhancements are designed to improve access to appropriate primary, specialty, dental, and behavioral healthcare for the program Enrollees.The Telephonic Case Manager provides telephonic outreach, disease and/or case management, education and support to plan Enrollees to support healthy lifestyle choices & to reduce long term effects of chronic illnesses. This individual performs other clinically based activities to coordinates care between the Enrollees, providers and community based health organizations. Responsibilities: Provides telephonic outreach in disease management and/or case management, education, enrollment and other clinically based activities to plan Enrollees. Conducts assessments, develops treatment plans and interventions and sets goals for treatment plans/behavioral modification within the scope of practice. Collaborates with Enrollees medical/health and community based providers (including the PCP, HCH, certified dieticians, behavioral health specialists, or others as needed) regarding the members treatment needs and plan of care. Collects clinical data and enters information into database for tracking and metrics purposes. Monitors and evaluates the services and community based resources necessary to respond to the individual Enrollees health needs. Completes other special assignments and projects as assigned.Education: Associates Degree in Nursing required, BSN/MSN preferred. Current, unrestricted RN licensure in PA is required. Professional certification (CCP-Chronic Care, CCM-Case Mgr) preferred.Qualifications: Minimum 3 years as staff nurse (acute care, case management). Previous experience in a care management, quality improvement, medical record reviews, disease management and/or case management preferred. Clinical background, preferably in quality, technology, or performance improvement. Knowledge of Medicare/Medicaid. Knowledge of adult learning and behavior change principles preferred. Knowledge of community based resources. Clinical assessment skills, consistent with state licensure scope of practice requirements. Excellent written & verbal communication skills. Strong telephonic interviewing skills. Proficient in Microsoft Office, Internet/Web Navigation. Prioritization and organizational skills needed. Ability to assess patient health status, consistent with state licensure scope of practice requirements. Ability to integrate data and evaluate to design meaningful interventions. Must be able to prioritize and target interventions, consistent with state licensure scope of practice requirements designed to support long term behavioral change.