Nurse Care Manager
Company DescriptionPrivia Health(TM) is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings.
The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
Job Description Develop trust and build rapport with a select Privia patient population with a goal of reduction in high cost utilization and improvement in clinical outcomes Collaborate across a variety of teams, including Payer Contracting, Care Management,Performance Management, and Analytics Develop and collaborate strategic relationships with payers, taking our group from fee-for-service to fee-for-value based care Engage patients telephonically, in office, in facility, or where needed Act as the liaison between the PCP, patient, and payer contract Attend and engage in operations meeting with payers Assist patients in accessing care at the appropriate source Holistic assessment of patients (medical, social, economic, behavioral) to identify opportunities or barriers to improve outcomes Work collaboratively with patient and care center teams to develop a plan of care to improve patient outcomes.
In-person and telephonic follow up with our high risk patient populations for education and collaborative goal setting to work towards improving patient outcomes and decreasing high cost utilization Where applicable all tasks, including assessments and care planning, are completed by a RN or LPN under the supervision of an RN, and follow established protocols and standing orders.
Understand and utilize the Athena and Privia Applications to identify high value opportunities to decrease utilization and close quality gaps Maintain a courteous and helpful manner when working with patients, physicians, and associates Participate in special projects and perform other duties as assigned Qualifications BS in Nursing (or equivalent) preferred and at least 3
years of case management or care coordination experience.
Active unrestricted license in VA, DC, MD or able to obtain (if needed) Strong computer and EHR skills and expertise Must comply with all HIPAA rules and regulations Additional InformationAll of your information will be kept confidential according to EEO guidelines.
Technical Requirements (for remote workers only, not applicable for onsite/in office work):
In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed.
This should be acquired prior to the start of your employment.
The best measure of your internet speed is to use online speed tests like https:
//www.
speedtest.
net/.
This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements.
Work with your internet provider if you have questions about your connection.
Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work.
Privia is a better company when our people are a reflection of the communities that we serve.
Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.
Recommended Skills Assessments Case Management Clinical Works Contract Management Coordinating Data Analysis Estimated Salary: $20 to $28 per hour based on qualifications.
The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.
Job Description Develop trust and build rapport with a select Privia patient population with a goal of reduction in high cost utilization and improvement in clinical outcomes Collaborate across a variety of teams, including Payer Contracting, Care Management,Performance Management, and Analytics Develop and collaborate strategic relationships with payers, taking our group from fee-for-service to fee-for-value based care Engage patients telephonically, in office, in facility, or where needed Act as the liaison between the PCP, patient, and payer contract Attend and engage in operations meeting with payers Assist patients in accessing care at the appropriate source Holistic assessment of patients (medical, social, economic, behavioral) to identify opportunities or barriers to improve outcomes Work collaboratively with patient and care center teams to develop a plan of care to improve patient outcomes.
In-person and telephonic follow up with our high risk patient populations for education and collaborative goal setting to work towards improving patient outcomes and decreasing high cost utilization Where applicable all tasks, including assessments and care planning, are completed by a RN or LPN under the supervision of an RN, and follow established protocols and standing orders.
Understand and utilize the Athena and Privia Applications to identify high value opportunities to decrease utilization and close quality gaps Maintain a courteous and helpful manner when working with patients, physicians, and associates Participate in special projects and perform other duties as assigned Qualifications BS in Nursing (or equivalent) preferred and at least 3
years of case management or care coordination experience.
Active unrestricted license in VA, DC, MD or able to obtain (if needed) Strong computer and EHR skills and expertise Must comply with all HIPAA rules and regulations Additional InformationAll of your information will be kept confidential according to EEO guidelines.
Technical Requirements (for remote workers only, not applicable for onsite/in office work):
In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed.
This should be acquired prior to the start of your employment.
The best measure of your internet speed is to use online speed tests like https:
//www.
speedtest.
net/.
This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements.
Work with your internet provider if you have questions about your connection.
Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work.
Privia is a better company when our people are a reflection of the communities that we serve.
Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.
Recommended Skills Assessments Case Management Clinical Works Contract Management Coordinating Data Analysis Estimated Salary: $20 to $28 per hour based on qualifications.
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