JOB SUMMARY

Under the supervision of the Director or designee, the registered nurse provides holistic, longitudinal, individualized member care in response to identified needs of low and moderate risk members. This position focuses primarily on the post-discharge calls made to members to optimize their safety and quality outcomes.

JOB SPECIFICATIONS AND CORE COMPETENCIES

• Provides and documents post-discharge call attempts and connections; escalates clinical needs quickly and closes all loops; advances complaints and grievances quickly and to the appropriate resource to ensure compliance with regulatory grievance requirements. Ensures member?s record, including Plan of Care is corrected or updated as needed. Ensures member has opportunity to ask questions and gain clarity on care plan and requested follow-up activities and care regimen.
• Engages in evidence-based best practices that enhance the member experience, including participating in interdisciplinary care team meetings as appropriate.
• Actively contributes to achievement of departmental goals, as identified in Department?s annual business plan, including specific departmental process improvement plans, and other duties as assigned.

MINIMUM QUALIFICATIONS:

• Education/Specialized Training/Licensure: Graduate of an accredited school of Professional Nursing.
• RN Licensure active in the State of Texas required.
• BSN Program preferred.
• Work Experience (Years and Area): 1 year experience in health plan setting.
• Software Proficiencies: Microsoft Office
• Other: N/A