High Risk RN Care Coordinator at One Medical

Phoenix, Arizona, United States -

Full Time

Start Date

Immediate

Expiry Date

12 Mar, 26

Salary

104000.0

Posted On

12 Dec, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Care Coordination, Case Management, Chronic Disease Education, Clinical Assessment, Patient-Centered Communication, Motivational Interviewing, Interpersonal Communication, Critical Thinking, Flexibility, Creativity, Health Insurance Navigation, Team Collaboration, Action Planning, Medication Reconciliation, Patient Empowerment, Healthcare System Navigation

Industry

Hospitals and Health Care

Description

About Us One Medical is a primary care solution challenging the industry status quo by making quality care more affordable, accessible and enjoyable. But this isn’t your average doctor’s office. We’re on a mission to transform healthcare, which means improving the experience for everyone involved - from patients and providers to employers and health networks. Our seamless in-office and 24/7 virtual care services, on-site labs, and programs for preventive care, chronic care management, common illnesses and mental health concerns have been delighting people for the past fifteen years. In February 2023 we marked a milestone when One Medical joined Amazon. Together, we look to deliver exceptional health care to more consumers, employers, care team members, and health networks to achieve better health outcomes. As we continue to grow and seek to impact more lives, we’re building a diverse, driven and empathetic team, while working hard to cultivate an environment where everyone can thrive. The Opportunity The One Medical at Home (OM@H) Program is seeking an experienced, Remote, full-time Registered Nurse with a Care Management or Case Management background to join our team. This is a fully virtual role supporting patients in multiple states/markets. The OM@H RN will support the care of One Medical Senior Health patients enrolled in the OM@H program by working with internal and external care team members to coordinate patient care. The OM@H RN will create appropriate action plans, triage patient phone calls, and manage transitions of care to acute and post acute facilities. The ideal candidate is goal oriented, uses critical thinking and creativity to address challenges, and is comfortable with ambiguity. You are skilled in chronic disease education and care management, and passionate about Seniors’ health and demonstrate outstanding clinical aptitude and judgment when caring for a patient. Employment type: Full time 40 hours per week Must be able to work Monday through Friday, 8AM - 5PM in Pacific Time Zone What you’ll be working on: Participate in daily huddles and weekly rounding with your assigned market care teams to review overnight calls, previous day triages, complex patient care needs, new facility admissions, pending facility discharges, and provider daily schedules Address tasks assigned to you by various team members for your patient panel including, but not limited to, lab results, medication questions, short term education needs, action plan requests, and triage follow up Work together with other RNs to respond to incoming patient calls across all markets that require nursing triage Respond timely to multiple Slack channels where team members post urgent needs throughout the day Serve as the primary liaison between partner providers and the patient’s primary care provider (PCP) team during time of transition, engaging in action planning, medication reconciliation, pre- and post-discharge planning, and facilitating safe handoffs of care Manage assigned patients with the purpose of helping them be more effective at managing their own care, understand their medical conditions and medications, navigate the healthcare system and utilize resources appropriately Create a patient centered-action plan with each patient and consistently document planned interventions and patient self-management strategies Address and resolve post-discharge barriers and potential readmission factors including home health, durable medical equipment, and social determinants of health Communicate significant clinical information regarding assigned patients to other members of the healthcare team and especially to the patient’s PCP Attend care coordination rounds and team huddles to support and facilitate patient care collaboration Effectively navigate health insurance policies and guidelines related to primary care, specialist, acute, rehabilitation and long term care Develop a positive working relationship with sponsor care management staff Build strong relationships with health systems and facilities, including facilitating coordination and communication channels Education, licenses, and experiences required for this role: AZ Licensed Registered Nurse (RN) required and ability to obtain licensure or already be licensed in other states/markets (GA, TX, AZ, CO) as this fully virtual role and coverage requires it 5+ years preferred of RN experience with at least 1 year care coordination/case management experience within the past 5 years. Demonstrated experience in complex care settings, senior health, or case management experience (preferred), ideally with understanding of home based care services, hospitals/ SNF and long term care facilities. Knowledge of the local market healthcare community is also preferred Demonstrated skill in chronic disease education and care management, comprehensive clinical assessment and care plan development, coordination across health care settings on behalf of very complex patient needs Advanced knowledge of utilization management/ care management principles A goal-oriented, high energy, passionate perspective with a focus on living organizational values and able to set the tone for a positive work culture Demonstrates outstanding clinical aptitude and critical thinking under pressure, using sound judgment in caring for patient needs. Comfortable operating in ambiguity, uses flexibility and creativity to address challenges Ability to use core coaching and teaching techniques, including motivational interviewing and patient-centered communication to activate and empower patients and families. Excellent interpersonal communication skills with a variety of audiences via telephone, in person, and electronic means including exceptional listening skills, ability to use appropriate language and demonstrated writing skills Promote and sustain a culture of safety Understanding of Mac iOS, Google suite One Medical providers also demonstrate: A passion for human-centered primary care for our senior members The ability to successfully communicate with and provide care to individuals of all backgrounds The ability to effectively use technology to deliver high quality care The desire to be an integral part of a team dedicated to changing healthcare delivery An openness to feedback and reflection to gain productive insight into strengths and weaknesses The ability to confidently navigate uncertain situations with both patients and colleagues Readiness to adapt personal and interpersonal behavior to meet the needs of our patients This is a full-time virtual role. One Medical is committed to fair and equitable compensation practices. The base salary range for this role is $89,000 to $104,000 per year. Total compensation packages may be based on factors unique to particular candidates, such skill sets, depth of experience, and work location. The total compensation package for this position may also include benefits. For more information, visit https://www.onemedical.com/careers/ One Medical offers a robust benefits package designed to aid your health and wellness. All regular team members working 24+ hours per week and their dependents are eligible for benefits starting on the team member's date of hire: Taking care of you today Paid sabbatical for every five years of service Free One Medical memberships for yourself, your friends and family Employee Assistance Program - Free confidential services for team members who need help with stress, anxiety, financial planning, and legal issues Competitive Medical, Dental and Vision plans Pre-Tax commuter benefits PTO cash outs - Option to cash out up to 40 accrued hours per year Protecting your future for you and your family 401K match Credit towards emergency childcare Company paid maternity and paternity leave Paid Life Insurance - One Medical pays 100% of the cost of Basic Life Insurance Disability insurance - One Medical pays 100% of the cost of Short Term and Long Term Disability Insurance In addition to the comprehensive benefits package outlined above, practicing clinicians also receive Malpractice Insurance - Malpractice fees to insure your practice at One Medical is covered 100%. UpToDate Subscription - An evidence-based clinical research tool Continuing Medical Education (CME) - Receive an annual stipend for continuing medical education Rounds - Providers end patient care one hour early each week to participate in this shared learning experience Discounted rate to attend One Medical’s Annual REAL primary care conference One Medical is an equal opportunity employer, and we encourage qualified applicants of every background, ability, and life experience to contact us about appropriate employment opportunities. One Medical participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. Please refer to the E-Verification Poster and Right to Work Poster for additional information.

Responsibilities

The OM@H RN will support the care of One Medical Senior Health patients by coordinating patient care with internal and external team members. Responsibilities include creating action plans, triaging patient calls, and managing transitions of care.