Market Support RN Coordinator

Key Tasks and Responsibilities:

• Participate in and coordinate all aspects of the Quality Improvement Program
• Analyze the medication adherence information that is shared from pharmacy team, track concerns or needs for closing gaps and communicate with the APP in the field as well as leadership team on the progress of closure
• Education of the field team on the Star and HEDIS measures
• Track and coordinate with team on closure of Star and HEDIS gaps
• Meet with the Market Director of Clinical Services and the market leadership team regularly to review quality progress and improvement plans
• Uses facility EMRs to prescreen new enrollees to determine any specific continuity of care needs for external appointments/specialists, etc. and facilitates their access
• Performs care coordination activities - member transitions of care communication to and from facility, assisting with Prior auth requests process, knowing how to access the drug formulary, provider directory and communicates member patients/families and doctors as delegated by team - Nurse Practitioners
• Participates in Longevity Health Plan standing clinical meetings on a daily/weekly monthly basis
• Assists with gathering data for hospitalization review sessions
• Proficient user of the LHP EMR as well as the facility EMRs and medication refill process
• Assist with organizing outside appointments for the members
• Performs other duties as assigned, or as required by the team and based on workload, which may include such things as tracking skilled therapy, MTMs, disenrollment's, etc

Supervisory Responsibilities:

• There are no supervisory responsibilities for this position

Licensure:

• Registered Nurse licensed in state of residence required
• Valid state driver's license with a good driving record required
• Auto liability insurance declaration page with minimum limits of $100,000/$300,000 for bodily injury and $100,000 for property damage with combined single limit of $300,000
• You will be responsible for providing this proof of coverage on an annual basis

Education and Training:

• Associate degree in nursing required, bachelor’s degree in nursing or other healthcare related discipline but must be a licensed professional registered nurse

Knowledge and Experience:

• Nursing home background or health plan case management experience preferred
• Minimum 2 years’ experience as a Registered Nurse
• Excellent verbal and written communication skills
• Excellent computer skills, EMR/clinical Platform/MS Office Products
• Knowledge of the challenges and opportunities to serve the long-term nursing home population
• Required to have managed care coordination background/experience
• Data analytic skills in a healthcare setting required
• Ability to prioritize work effectively
• Critical thinking and effective decision making
• Computer, MS Office PPT, Excel, MS Word, Teams, Outlook skills required
• Project management skills preferred