Care Manager RN Coach
Requisition Number: 28346 Job Location: Pittsburgh, PennsylvaniaPremise Health is the world's leading direct healthcare provider and one of the largest digital providers in the country, serving over 11 million eligible lives across more than 2,500 of the largest commercial and municipal employers in the U.S. Premise partners with its clients to offer fully connected care – in-person and in the digital environment. It operates more than 800 onsite and nearsite wellness centers in 45 states and Guam, delivering care through the Digital Wellness Center and onsite, nearsite, mobile, and event solutions.
We offer more than 30 products, delivering the breadth and depth of care required to serve organizations' total populations. The result is healthcare that meets the needs of members and their families, helping them live healthier while lowering costs for organizations.
ABOUT THE ROLE:
- RN position that leverages powerful data insights to proactively identify and engage members who need support the most. Nurses will design individualized care plans, offer self-management education and coordination of resources that assists members to achieve improved health. Collaborates closely with clinical teams to provide guidance on engagement strategies, focused on improving health status of members. Manages a panel of high-risk members with chronic conditions to provide frequent touchpoints and ensure care gap closure as defined by national standards. Facilitates Care Team meetings to ensure an interdisciplinary approach to care for member panel.
- This is an incredibly rewarding role that allows you to focus on what’s most important – helping people, and the organizations they work for, get, stay and be well!
- Great work life balance. The schedule is Monday through Friday 8-8:30am to 4:30-5:00pm. No Weekends and 10 Holidays a year!
ESSENTIAL JOB FUNCTIONS
- Develops personalized treatment plans using provider care plans and member preferences using a coach approach and the pillars of Lifestyle Medicine
- Supports a proactive, multidisciplinary team approach directed toward prevention, education and health promotion
- Establishes supportive relationship with members
- Assesses member’s educational/clinical/social needs, prioritizing care based on elicited information from the member, Epic, and data analysis
- Acts as resource for members
- Documents touchpoints and progress into the electronic medical record
- Collaborates with the full scope of clinical team members to arrange for further medical treatment when needed
- Provides support and tools needed to help members take control of their health
- Delivers exceptional member experiences and engaging members in their healthcare journeys
- Improves health outcomes and better management of any chronic condition
- Lowers healthcare costs while improving outcomes
- Consults with other members of the healthcare team to solve problems and seek advice
- Works closely with client’s vendors as appropriate to support member’s needs where appropriate
- Identifies emergency situations and provides care within legal scope of practice
- Maintains member privacy and confidential member information
- Participates in outreach/follow-up phone calls and follow-up member visits
- Provides condition specific self-care education to client employee enrolled in the various condition management programs
- Serves as member advocate
- Acts as facilitator of Care Team meetings.
- For clients with CC+, proactive outreach to high-risk members identified through claims data
- Coaches effectively virtually using video and phone
- Collaborates with health center staff to coordinate and promote health and wellness programs
- May require other duties as assigned.
BASIC QUALIFICATIONS
Education:
- Currently licensed Registered Nurse in state of practice
- Current certification AHA or ARC Basic Life Support for health care providers
- Current Wellness Coach Certification from Wellcoaches® OR equivalent International Coach Federation-accredited program certification (must be obtained within 24 months of hire) Reimbursement available for certifications with prior approval.
- Bachelor's degree (BSN) from four-year college or university (preferred)
Experience:
- At least three years’ experience as a Registered Nurse caring for members with any of the following conditions: Type 2 diabetes, asthma, heart disease, heart failure or hypertension.
- Experience in Condition Management, Certificate in Case Management, Care Coordination, Certified Diabetes Educator (CDE) Certified Diabetes Care and Education Specialist (CDCES) a plus
Work-life balance is at the foundation of how decisions are made and where Premise is headed. We can only help people get, stay, and be well if we do the same for ourselves. In addition to competitive pay, Premise offers benefits packages including medical, dental, vision, life insurance, 401(k), paid holidays and vacation time, a company-sponsored wellness program, and much more our talent acquisition team will be happy to share with you.
Premise Health is an equal opportunity employer; we value inclusion, and we do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status or disability status.