Disease Management RN II vacancy at Blue Cross Blue Shield of LA in Baton Rouge

Blue Cross Blue Shield of LA is currently seeking to employ Disease Management RN II on Sat, 20 Oct 2012 21:07:29 GMT. Baton Rouge, Louisiana • Disease Management RN II Now Hiring! Immediate opportunities available for RNs in Utilization Review, Disease Management and Case Management Immediate opportunities for RNs licensed to practice in Louisiana required. Bachelor’s Degree in Nursing or health related field is preferred. Chronic Disease Management Certification preferred or must be attained within 36 months...

Disease Management RN II

Location: Baton Rouge Louisiana

Description: Blue Cross Blue Shield of LA is currently seeking to employ Disease Management RN II right now, this vacancy will be placed in Louisiana. For detail informations about this vacancy opportunity please give attention to these descriptions. Baton Rouge, Louisiana

• Disease Management RN II

Now Hiring! Immediate opportunities available for RNs in Utilization Review, Disease M! anagement and Case Management

Immediate opportunities for RNs licensed to practice in Louisiana required. Bachelor’s Degree in Nursing or health related field is preferred. Chronic Disease Management Certification preferred or must be attained within 36 months. Related nursing specialty certification can be used in lieu of CDMC. Three years of direct patient care/clinical experience required, or two years direct patient care/clinical experience plus case or chronic disease management certification. Experience in research and analysis of contracts/cases and in making appropriate quality and cost effective decisions. Ability to work independently and make decisions and with general supervision plan, implement and evaluate appropriate healthcare services in conjunction with a physician treatment plan evaluating the effectiveness of alternate care services. Experienced in use of behavioral interviewing techniques and theory required. Demonstration of strong communica! tion skills, including the ability to effectively explain/pres! ent claims information and procedures to persons with varied levels of health literacy and insurance/benefits understanding. Ability to quickly establish rapport over the telephone and complete telephonic assessments as indicated through work experience. Able to travel within the state, if needed.

Responsible for assessment of members’ health status by collecting and analyzing in-depth information across seven dimensions of health (clinical, functional, financial, support system, psycho-social, cognitive, and environmental) and to develop, and implement individualized care plans with appropriate disease management interventions and services in a culturally sensitive way. Evaluates benefits and alternative care services in conjunction with the physician treatment plan to facilitate cost effective, quality care and self care. Assists with benefits management as needed. Monitors effectiveness of plan by gathering sufficient information from relevant sources in order! to intervene, as appropriate to improve health outcomes.

Responsible for stratification of members to appropriate program level of intervention and evaluation of stratification level using defined criteria no less than every six months for members in case load. Responsible for identification of major health risk factors, reinforcement of physician’s plan of treatment, and assisting members to set goals and achieve self care objectives. Acts as liaison between member, employer, providers, support system and health plan. Responsible for prioritizing interventions based on clinical need and readiness to change. Educates and works with members at different educational and health literacy levels. Responsible for meeting individual quality performance standards and annual targets for program performance as mutually agreed to by management team to maximize program value. May provide guidance to less experienced nurses. Responsible for meeting targets for program perfor! mance, such as monthly productivity and annual caseload requirements as! mutually agreed to by management team to maximize program value. Prepares case reviews and summaries of member management activities for management and client review. The Disease Management RN II position reports to a Supervisor, Disease Management. This position is a grade 13.

For more information or to apply visit our website at www.bcbsla.com Blue Cross and Blue Shield of Louisiana is an Equal Opportunity and Affirmative Action Employer
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If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to Blue Cross Blue Shield of LA.

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This vacancy starts available on: Sat, 20 Oct 2012 21:07:29 GMT

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