DescriptionIntroductionLast year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Care Manager WFH with HCA Healthcare you can be a part of an organization that is devoted to giving back!Must be located in the Portsmouth, NH area to visit practices and attend onsite meetings as required.Job Summary & QualificationsThe Care Manager supports the patient and primary care relationship through care delivery enhancement. Primary mechanisms for this support are telephonic outreach to patients to guide them through transitions of care, care management, preventive services, and self-management. The Care Manager acts as an integral member of the division Care Coordination team supporting PSG primary care providers and practices in successfully meeting quality improvement initiatives in assigned division(s).What you will do in this role:General
Serves as a subject matter expert in quality and value-based care programs such as MIPS, ACOs, and payor pay-for-performance contracts. Assists in educating practice staff on quality, payor, and government program requirements
Develops professional working relationship with HCA/PSG primary care providers, practice managers, and their staff to collaboratively manage follow-up care and improve overall health and wellness
Assists in the development of tools, education and workflow processes to assist the division(s) in meeting CMS, ACO, documentation, and payor quality initiatives
Collaborates with interdisciplinary teams and leaders (PSG, Payer Contracting & Alignment, Quality and Payor Initiatives) to achieve the organization’s coordination of care goals, quality goals, and financial performance goals
Conducts in-person and virtual meetings with practice managers, staff, providers and managers to communicate program goals, results, and provide education
Care Gaps
Monitors patient compliance with preventive screening and/or behavioral health management processes using internal and payor reporting tools
Accesses portals as necessary to prepare reports and other documents to evaluate progress and prioritize workload
Communicates via telephone and other virtual tools with patients regarding care needs, documenting communications appropriately in the electronic medical record
Prepares and maintains patient charting as needed and performs medical record reviews for payor projects
Assists in securing and submitting necessary documentation for annual patient assessment forms (PAFs)
Understands and addresses short term behavioral health care gaps as needed
Transitions of Care
Contacts patients after an emergency department encounter or hospital discharge to identify the need for a follow-up appointment, community resource needs, etc.
Documents assessment in the medical record to support transition of care services as specified by CMS and other program requirements
Care Management
Triages patients to determine those appropriate for medical and/or behavioral care management
Creates a care management action plan with the patient/caregiver that includes elements of self-management, as appropriate
Identifies and enrolls eligible patients in longitudinal or chronic care management for medical or behavioral health conditions
Oversees the execution of patient care plans in partnership with Care Coordinators
Facilitates specialty referrals, as appropriate, for conditions/needs managed outside the primary care realm
Population Health
Assists with practice and provider empanelment processes
Schedules appointments related to preventive care, chronic disease management, and/or integrated behavioral health
Prepares and maintains care coordination reports and provides periodic updates to practice leaders and providers
What Qualifications you will need:
Graduate of an accredited college of nursing required
Knowledge of physician office practice operations and one (1) year of experience in a physician practice is preferred
Current licensure as an RN in the state of residence and/or practice
Must be located in the Portsmouth, NH area to visit provider practices and attend onsite meetings as required
BenefitsHCA Healthcare offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
Free counseling services and resources for emotional, physical and financial wellbeing
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
Employee Stock Purchase Plan with 10% off HCA Healthcare stock
Family support through fertility and family building benefits with Progyny and adoption assistance.
Referral services for child, elder and pet care, home and auto repair, event planning and more
Consumer discounts through Abenity and Consumer Discounts
Retirement readiness, rollover assistance services and preferred banking partnerships
Education assistance (tuition, student loan, certification support, dependent scholarships)
Colleague recognition program
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)Note: Eligibility for benefits may vary by location.Physician Services Group is skilled in physician employment, practice and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ urgent care centers. We are HCA Healthcare’s graduate medical education leader. We provide direction for over 260 exceptional resident and fellowship programs. We focus on carrying out value-added solutions. These solutions help physicians deliver patient-centered healthcare. We support HCA Healthcare's commitment to the care and improvement of human life.HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.""There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.HCA Healthcare Co-FounderBe a part of an organization that invests in you! We are reviewing applications for our Care Manager WFH opening. Qualified candidates will be contacted for interviews. Must be located in the Portsmouth, NH area to qualify. Submit your application and help us raise the bar in patient care!We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.