Yavapai Regional Medical Center

  • ACO Case Manager

    Job Location US-AZ-Prescott
    Job ID
    14192
    FTE
    1
    Shift
    1
    Department
    Accountable Care Organization (ACO)
    Job Family
    Nursing
    Facility
    Wellness Center-Accountable Care Organization
  • Job Summary

    The ACO Case Manager supports the vision of the Total Healing Environment and the values of respect, integrity, accountability, commitment and quality working with ACO members, providers and caregivers to provide intensive, comprehensive case management and increasing efficient utilization of services; identifies chronic or catastrophic cases through the case management process and initiates intensive case management according to program guidelines. Effectively manages patients on an outpatient basis to assure the appropriate level-of-care is provided to prevent inpatient re-admissions and ensure that the patient's medical, environmental and psychosocial needs are met over the continuum of care. Acts as an advocate for members and their families, linking them to other members of the care team to help them gain knowledge of their disease process and to identify community resources for continued growth toward a maximum level of independence.

    Job Qualifications

    Required Qualifications:

    • Graduate from an accredited school of nursing
    • Current, valid Arizona or compact RN state license
    • Three years of experience in hospital or managed care case management or utilization review
    • Knowledge of federal, state and managed care rules and regulations including CMS and AHCCCS
    • Current American Heart Association (AHA) BLS for Healthcare Provider certified
    • Basic computer literacy and proficiency in Microsoft Windows
    • Intermediate proficiency in Microsoft Word with the ability to compose documents in a professional writing style; basic proficiency in Microsoft Excel
    • Excellent oral and written communication skills
    • Excellent interpersonal skills with ability to interact with all levels of the organization and with external contacts
    • Ability to engage the geriatric population over the phone
    • Ability to prioritize, plan and handle multiple tasks/demands simultaneously

    Preferred Qualifications:

    • BSN
    • Certified Case Management (CCM) Certification
    • Managed Care Organization experience
    • Experience with INTERQUAL or Milliman
    • Hospice experience strongly preferred
    • Bilingual English/Spanish
    • Electronic Medical Record (EMR) experience; Cerner strongly preferred

    *Must pass pre-employment screening

    Company Overview

    Yavapai Regional Medical Center is a not-for-profit, integrated healthcare provider that offers a broad range of inpatient and outpatient services. Our healing network includes two full-service acute care hospitals, primary and specialty care clinics, the YRMC Wellness Center and the YRMC Del E. Webb Outpatient Center. YRMC's unmatched continuum of care covers a 5,500 square mile service area and includes cardiac surgery, neurosurgery, a comprehensive Women's Health Pavilion and Arizona's only Patient Blood Management Program. YRMC has earned numerous awards for quality and has earned national recognition as an exceptional provider of care.

    Our Mission
    To provide comprehensive, high quality healthcare consistent with our communities' needs.

    Our Vision
    Creating a "Total Healing Environment" wherein the people of YRMC work in partnership with the patients and their families seeking peace of mind and peace of heart as well as physical cures or comfort because we understand the indivisible relationship that exists between body, mind and the human spirit.

    Our Values
    Respect: Behaving in a way that honors self and others.
    Integrity: Being consistent and honest in word and deed.
    Accountability: Following through and being answerable for one's performance.
    Commitment: Demonstrating dedication to one's work, personal development, the organization, the Mission and the Vision.
    Quality: Providing service excellence.

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