Job: RN Healthcare Coordinator

Jobing Description

Job Description - RN Healthcare Coordinator (11003314)

Job Description

RN Healthcare Coordinator(

Job Number:
11003314)

Description

Xerox Corporation is a $22 billion leading global enterprise for business process and document management. Through its broad portfolio of technology and services, Xerox provides the essential back-office support that clears the way for clients to focus on what they do best: their real business. Headquartered in Norwalk, Conn., Xerox provides leading-edge document technology, services, software and genuine Xerox supplies for graphic communication and office printing environments of any size. Through ACS, A Xerox Company, which Xerox acquired in February 2010, Xerox also offers extensive business process outsourcing and IT outsourcing services, including data processing, HR benefits management, finance support, and customer relationship management services for commercial and government organizations worldwide. The 130,000 people of Xerox serve clients in more than 160 countries.

If you meet the requirements of this position and want to work for a world-class company with a great marketplace reputation, apply today.

SUMMARY OF THE POSITION:

Acts as patient/family advocate in coordinating and accessing medical necessity health care services within the benefit plan for members that have complex and catastrophic conditions.

ESSENTIAL DUTIES & RESPONSIBILITIES:

Adheres to all Company policies, procedures, and rules.

Adheres to all safety-related policies, procedures, and rules. Promotes a safety awareness and commitment at all times.

Interacts professionally and efficiently with other ACS Bowers employees to achieve the Company s Vision and Mission Statement.

Establishes and maintains effective working relationships with patients and their families, providers and payers.

Maintains confidentiality of information of received, provided, or processed. Signs and adheres to the ACS Bowers Confidentiality Agreement.

Identifies cases for individual management from predictive modeling data, information collected from patients, providers, and caregivers. Conducts thorough assessment, develops and implements a management plan, including goals, as appropriate.

Uses established evidenced based guidelines/criteria to evaluate treatment plans and goals based on information obtained from attending physician and/or other providers. Refers cases that do not meet evidenced based guidelines/criteria to appropriate clinical advisor.

Refer patients to appropriate resources to allow for positive outcomes relating to their disease state.

Manages case to conclusion, while maintaining contact with all individuals involved. Makes modifications as appropriate. Ensures that the goals identified in the case management plan are met.

Regularly interacts with Third Party Administrators to exchange certification information.

Educate and assist patients in understanding their condition to improve self management and maximize their health status potential.

Identifies potential cost savings within a health plan s coverage. Acts upon cost savings in instances when services would not be sacrificed by doing so.

Acts as primary contact with designated patients and providers.

Travels to client (employer) sites for meetings as needed. Requires valid driver s license.

Travels to patient s locations to conduct coordinated care activities. Requires valid driver s license.

Participates in quality improvement strategies by assessing individual and employer satisfaction of programs. Identifies and addresses quality issues.

Participates in continuing education (internal and external providers) in order to maintain active case management certification, other certifications, individual state licensures, and clinical management expertise.

Participates in professional nursing organizations.

Conducts research as appropriate, to obtain/maintain knowledge of cultural differences including socioeconomic factors, cultural traditions, and spiritual beliefs.

Assists in the implementation and adherence to policies, procedures, and new programs related to Case Management and Quality Improvement.

Obtains/maintains knowledge of Federal, State, and Local regulations, funding, and community resources available to patients and their families.

Performs all job duties and responsibilities within the scope of State & Federal laws, licensure/certification as well as within the ethics described in the CMSA s Standards of Practice.

Collaborates with other departments to promote coordination and communication within the Company regarding integration of administrative activities, quality improvement, and clinical operations.

Ability to read and interpret Summary Plan Documents and other related resources relating to services requested.

Adheres to URAC standards for programs which ACS Bowers is currently accredited.

Other duties and responsibilities as assigned.

EXPERIENCE:

Minimum of 3 years nursing experience in an acute care or relevant setting.

Proficiency in basic computer skills including Microsoft Windows and Works (others as identified by supervisor), and the ability to access and navigate the Internet, to conduct research.

Effective communication skills verbal, written, interpersonal, and phone, in order to interact with internal departments and external contacts.

Accurate spelling, grammar, and documentation preparation skills.

Ability to attend to numerous details under the stress of maintaining courteous, accurate and timely relations with a variety of individuals.

Ability to work independently, with minimal supervision.

Ability to apply common sense understanding in carrying out detailed written or oral instructions.

Ability to comprehend the consequences of various problem situations and to refer such problems to the appropriate individual (or supervisor) for decision-making.

Ability to establish and maintain effective working relationships with co-workers and department managers, and medial providers.

Ability to work with a wide range of personalities in a courteous, effective, and efficient manner, representing ACS Bowers in a professional manner.

EDUCATION/LICENSURE/CERTIFICATION:

Appropriate RN licensure with active and unrestricted license to practice in the state of MO.

Certification in appropriate field of expertise, preferred.

All other duties as assigned.

ACS is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender/sex, marital status, sexual orientation, physical or mental disability, use of a guide dog or service animal, military/veteran status, citizenship status, the basis of genetic information or any other group protected by Federal or State law or local ordinance. People with disabilities who need a reasonable accommodation to apply or compete for employment with ACS may request such accommodation(s) by calling 866-419-2226 or by sending an e-mail to accommodations@acs-inc.com.