Conifer Care Continuum

Manages accounts using the 4-Prong approach, meeting expected number of billable hours and using Conifer Value Based Care tools ( CCOO) according to standard protocol.. As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide.. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare.. ~ Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.. ~ For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.

travel registered nurse

JOB SUMMARY  CCCS uses a holistic approach to medical management. The Personal Health Nurse (PHN) works within a team to move the member through the continuum of medical management with the goals of facilitating quality health care through the most cost effective means. The PHN performs the Personal Health Management process: assess the member; work with the member, family and physician to identify problems; establish goals and develop plans of care; coordinate services; educate members; and empower members to independently self-manage and to make knowledgeable health care decisions. The PHN works closely with the provider(s) to ensure that services are provided in the most appropriate setting by the appropriate provider(s) by performing functions of Personal Health Management as well as some functions of Utilization Management. Additionally, the PHN interfaces with clients and with CCCS client managers and are responsible for the medical management of designated client(s). All Medical Management Nurses practice within the scope of their licensures. 
 ESSENTIAL DUTIES AND RESPONSIBILITIES 
 Include the following. Others may be assigned. 
 Manages accounts using the 4-Prong approach, meeting expected number of billable hours and using Conifer Value Based Care tools ( CCOO) according to standard protocol. Documents accurate Status, Sub-status, Patient Severity, Medical Management Acuity 
 Reviews daily calendar for new episodes and tasks due, prioritizes tasks on calendar 
 Completes a Personal Health Management assessment incorporating analysis of clinical claim chart, discussions with the member and the physician’s assessment and treatment plan 
 Determines and documents member’s goals, engages the member in the personal health management process. Develops an ongoing individualized plan of care with timeframes, reasonable and appropriate expected outcomes, specific planned interventions and member’s goals. Follows through with interventions and documents outcomes in Current Clinical Status section of care plan 
 Engages the PCP and treating physicians in the personal health management process, Collaborates with the member and PCP in development of an individualized plan of care 
 Closes episodes as indicated, i.e. evaluates “Impactability” among other indications for closure. 
 KNOWLEDGE, SKILLS, ABILITIES 
 To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 
 Understanding of CCCS holistic approach to medical management 
 Understanding of the client’s (customer’s) perspective and needs 
 Understanding of legislative acts, such as the ADA 
 Competency in Word 
 Competency using email, attachments 
 Excellent verbal communication skills with the ability to communicate with members and communicate professionally with individuals who serve in a variety of functions, i.e. physicians, client managers, customer service staff, CCCS executive management, other CCCS Medical Management nurses, hospital utilization review nurses, etc. 
 Excellent written communication skills with the ability to write in a professional, business manner 
 Ability to analyze and resolve complex problems 
 General understanding of cost containment and how it relates to medical management 
 Excellent organizational, prioritization, and time management skills 
 Ability and willingness to function both independently and as part of a team 
 Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. 
 EDUCATION / EXPERIENCE 
 Include minimum education, technical training, and/or experience preferred to perform the job. 
 Bachelor’s degree in a health-related field 
 Five (5) years of UM/CM experience preferred 
 Three to five (3-5) years of diverse clinical experience required 
 CCM preferred 
 REQUIRED CERTIFICATIONS/LICENSURE 
 Include minimum certification required to perform the job. 
 RN (Registered Nurse) license required 
 Current active professional license in the state of residence 
 Eligibility for unrestricted professional licenses in all states 
 PHYSICAL DEMANDS 
 The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   
 Must be able to work in sitting position, use computer and answer telephone 
 Ability to travel 
 Includes ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments 
 WORK ENVIRONMENT 
 The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 
~ Remote Work Environment 

 TRAVEL 
~ Approximately 5 – 30 % travel may be required dependent on the client assigned 

 As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
 
 Compensation and Benefit Information 
 Compensation 
 Pay: $64,168.00-$96,262.00 annually. Compensation depends on location, qualifications, and experience. 
 Management level positions may be eligible for sign-on and relocation bonuses. 
 Benefits 
 Conifer offers the following benefits, subject to employment status: 
~ Medical, dental, vision, disability, life, and business travel insurance 
~ Paid time off (vacation & sick leave) – min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked. 
~401k with up to 6% employer match 
~10 paid holidays per year 
~ Health savings accounts, healthcare & dependent flexible spending accounts 
~ Employee Assistance program, Employee discount program 
~ Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. 
~ For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act. 

2403010996
 Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

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