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RN Case Manager - ADvantage Program Job Details

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Job Title:  RN Case Manager - ADvantage Program
Job Ref No:  22247347
Location:  Oklahoma
City:  Oklahoma City
Post Code:  73101
Job Description:  The homecare industry is revolutionizing healthcare in America. And Gentiva is leading that revolution with exceptional clinical care, innovative solutions and uncompromising service. We offer a unique employment package for nurses that includes comprehensive benefits, a flexible schedule and unprecedented opportunities for growth and specialization.

RN Case Manager - ADvantage Program: 
  • Initiates and oversees Service Plan and the ongoing monitoring of the provision of services included in the Service Plan. 
  • Reassesses the Members care needs annually, or sooner if there are changes in Member status. 
  • Documents case management activities in an accurate and timely manner in accordance with Gentiva's policies and practices. 
  • Assures that Members receive appropriate, quality services and that services are modified to meet changing Member needs; interventions are made to assure the system is responsive to Members; and the plan of care is progressively moving the individual toward self-care and preventing further loss of function. 
  • Assists Members to recognize and identify their service needs; educates Members on the quality and appropriateness of services; supports Members to take responsibility for their own care to the greatest extent possible; and, when necessary, represents Members in interactions with OKDHS program administration. 
  • Assures Members level of care and Advantage program participation appropriateness for Medicaid case management.
  • Compares contract authorizations/utilization guidelines (if applicable) to service plan and assists in determination of authorized services. 
  • Participates in case management meetings to provide on -going case management consultation and follow-up with the Clinical Manager as necessary for identified Members. 
  • Participates in ongoing performance improvement activities as assigned, and documents information enabling data collection/root cause analysis needed to identify opportunities for improvement. Ensures compliance with regulatory organizations. 
  • Attends/participates in staff development programs and obtains continuing education as required by company policy and licensing bodies. Interacts with field staff, referral sources to facilitate communications, answer questions and resolve problems. 
  • Assists in implementing/maintaining standardized operational processes to ensure compliance to company policies, legal requirements and regulatory mandates. Ensures the confidentiality of patient documentation.

 

Qualifications

Associates must meet one of three (1 of 3) minimum requirements as established by the Oklahoma Department of Human services set forth for the Advantage program.

1)     RN with one year paid professional experience

2)     LPN with one year paid professional experience

3)     Baccalaureate degree and one year's paid professional experience with gaining or disabled population, performing duties which encompass the core functions of casement management (assessment, planning, implementation, monitoring and reassessment).

Additionally, all associates must pass the Advantage Waiver Certification Training Course.

  • Must have excellent negotiation, communication and problem solving and decision making skills.



expect more from Gentiva
We give you everything you need to make the most of your career, including advanced education and training, the latest resources and the industry's highest standards of clinical excellence. When you work for a Gentiva company, you can expect more: more opportunities, more challenges, more rewards. That's why we're the employer of choice for some of today's most experienced and talented clinicians.

*Gentiva Health Services, Inc. is an Affirmative Action/Equal Opportunity Employer M/F/D/V encouraged to apply.

To learn more, please contact your local recruiter at (toll free) 1.866.GENTIVA.
Employer:  Gentiva Health.
01/03/2012

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