SpringfieldMARecruiter Since 2001
the smart solution for Springfield jobs

RN/BH Care Partner

Company: Commonwealth Care Alliance
Location: Springfield
Posted on: November 17, 2021

Job Description:

  • Facilitates preventative and basic primary care to members, as needed, per CCA standard operating procedures, commonly accepted medical guidelines, and appropriate scope of
  • Provides regularly scheduled telephonic calls to support the management of chronic disease or end of life/
  • Assist the member with understanding their CCA Health Benefit package
  • Performs annual comprehensive telephonic assessments and coordinates any needed follow up from results
  • Coordinates a host of benefits such as transportation, LTSS, interpreter services, hospice services, and more.
  • Adheres to appropriate and complete documentation practices, including: history of present illness, adjustment or maintenance of an established treatment plan, and consistent follow up of the plan as evidenced in the
  • Performs episodic urgent medical/ behavioral health telephone calls and facilitates such visits are conducted in-person for applicable members on panel to ensure that timely and appropriate medical care in order to avoid emergency department visit or
  • Liaises with CCA interdisciplinary site team where applicable to ensure comprehensive member needs are consistently met
  • Manages panel-wide and member-specific utilization trends
  • Liaises with CCA and community-based PCPs/specialists
  • Collaborates with the Transitions of Care Team on all medical and psychiatric admissions to assist in discharge planning
  • Reviews approved authorizations to assess appropriate utilization, based on members' needs
  • Actively participates in the evaluation of own performance and progress
  • Participates in activities and education to maintain and advance competency
  • Participates in CCA quality improvement efforts
  • RN: Associate degree or Diploma in Nursing
  • Must have an active RN license in good standing in the state assigned, may require multiple state licenses based on product
  • BH for SCO and ICO only: Master's Degree with one of these licenses in the applicable state: LCSW, LICSW, or LMHC. Preferred: LICSW or LMHC.
  • RN: BSN or related healthcare Degree preferred RN/BH: CCM preferred
  • RN: 2+ years meaningful clinical experience in primary care or care management including telephonic based setting, home health or acute care case management. Past experience caring for patients/members with complex medical, behavioral health, and social needs strongly preferred. BH: LCSW/LICSW/LMHC with 3-5 years 3-5 years Meaningful clinical experience in community case management, EAP, telephonic case management or primary care. Past experience caring for patients/members with complex medical, behavioral health, and social needs strongly preferred.
  • Experience with a Medicare Advantage population preferred.
  • Ability to use SBAR Communication
  • Ability to utilize an Electronic Medical Record or other electronic platforms
  • Ability to use on-line training platforms
  • Demonstrated understanding of CCA's Model of Care
  • Demonstrated understanding of the benefits of CCA
  • Ability to review welcome packets and obtain consent forms and attach them to EMR
  • Ability to complete and update a Care Plan that meets CCA requirements
  • Demonstrated understanding of LTSS
  • Demonstrated understanding of how to use CDSTs when ordering services
  • Ability to create referrals and authorize services within appropriate time frames
  • Ability to complete and lock all required telephone encounters within 48 hours
  • Ability to lead a family/team meeting for the purposes of discharge planning
  • Demonstrated knowledge and ability to use screening/ assessment tools (e.g., Fall risk assessment, mini cog assessment, nutritional assessment, PHQ 2, PHQ 9, BH)
  • Ability to conduct Crisis assessments over the phone and deploy assistance as needed
  • Demonstrated ability of how to locate current guidelines for recommended screening tests and immunizations
  • Demonstrated understanding of Referral to Specialists
  • Demonstrates the ability to utilize virtual care platformsEnglish required,bilingual preferredEqual Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Keywords: Commonwealth Care Alliance, Springfield , RN/BH Care Partner, Healthcare , Springfield, Massachusetts

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Log In or Create An Account

Get the latest Massachusetts jobs by following @recnetMA on Twitter!

Springfield RSS job feeds