Case Manager, Disease Management

Birmingham:Disease Management Case Manager

 

HealthSpring, a health maintenance organization is dedicated to improving the health of the community we serve by delivering the highest quality and greatest value in healthcare benefits and services.

 

We are seeking an experienced Disease Management Case Manager for our Health Services Department at our Birmingham office.

 

The Disease Management Case Manager will assist in disease management of chronic care patients through education, monitoring, member and provider interventions.  Assists in coordination and supervision of daily operations of the Disease Management Specialists.  Supports provision of high quality, cost effective clinical care through efficacious relationships with healthcare providers.

 

Responsibilities include:

· Identify treatment and education opportunities for members with chronic disease (s).

· Proactively assist in preventing patient ER and acute admissions when possible by emphasizing prevention of exacerbations and complications utilizing cost-effective practice guidelines including patient self-management.

· Facilitate the improvement of patient compliance via telephone follow-up and other methods.

· Evaluate each case for quality of care, documents quality issues and appropriately refers questionable outcomes to quality management staff.

· Assists in communicating and overseeing the operation of third party vendors regarding members in the program to include coordination and service delivery, and cost analysis if applicable.

· Assists in data collection and report compilation.

· Other duties as assigned.

 

Supervisory Responsibilities:Assist in overseeing daily operations of assigned Disease Management Specialists.

 

Job Related Skills:Verbal and written communication skillsInterpersonal skillsMathematical and statistical abilityOrganization skillsComputer knowledgeKnowledge of utilization review requirements and proceduresKnowledge of current health care practices and appropriate treatmentsKnowledge of community resources

 



Requirements include:Current licensure as a registered nurse in the state of Alabama.Five (5) years recent experience in an acute care environment, or Two (2) years recent experience in case management or utilization managementPrefer Certified Case Manager.Experience in Chronic Disease managementOne (1) year of previous Disease Management experience preferred.

 

 

HealthSpring of Alabama offers a competitive salary and a full range of benefits.

 

For more information and to apply visit, http://www.myhealthspring.com/employment.php?smkt=al, click Apply, and complete an online application.

 

Select Department:Health Services

Select Position:   Case/Disease Manager (for application purposes)





 

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HealthSpring, Inc. is an EEO/AA employer.