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This position collaborates with patients and primary care providers to ensure patients receive quality, efficient, and cost-effective healthcare services. Coordinates, monitors, and evaluates all options and services to optimize a patient's health status.

MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Current unencumbered licensure with the WV Board of Registered Professional Nurses, or appropriate state board where services will be provided, as a registered professional nurse OR current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). 2. Associate's Degree in Nursing AND Five years clinical experience in a healthcare setting OR Bachelor's Degree in Nursing AND Three years clinical experience in a healthcare setting. 3. West Virginia state criminal background check required, and Federal, if applicable, for DHHR regulated area.

PREFERREDQUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Bachelor's degree in Nursing (BSN) EXPERIENCE: 1. Three (3) years of disease management experience.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Ambulatory Utilization Management, Financial Management and Quality Screening for assigned patients.
2. Identifies the targeted population and risk stratifies all patients to prioritize needs and direct interventions.
3. Communicates and collaborates with inpatient and outpatient case management to implement the discharge plan and coordinate a safe transition to the next level of care.
4. Works in collaboration with physicians/providers, patients, and their families to ensure safe and efficient transitions of care.
5. Works collaboratively with patients to design an individualized plan of care that ensures coordination of services by the healthcare team.
6. Collaborates with available social services for appropriate resource and financial management which may include, but is not limited to financial assistance coordination/referrals, entitlement program coordination/referrals, patient benefit coordination, assessment for appropriate usage of Health Care Resources/clinical cost efficiency.
7. Coordinates/facilitates patient progression throughout the continuum, Transitional Planning, Advocacy and Education:
8. Clinical performance improvement, outcome management and quality activities.
9. Uses data to drive decisions and... For full info follow application link.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. Please view Equal Employment Opportunity Posters provided by OFCCP here. The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)