As a part of the Tenet and Catholic Health Initiatives family, Conifer Health Solutions is a leading healthcare business process management services provider working to improve operational performance for more than 800 clients so they can support financial improvement, enhance the patient experience, and drive value-based performance. Through our revenue cycle management, patient communications, and value-based care solutions, we empower healthcare decision makers—hospitals, health systems, physicians, self-insured employers, and payers—to better connect every point of care and wellness management. 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!
Conifer Health Solutions is currently hiring for a RN Case Manager/ Personal Health Nurse.
IMMS uses a holistic approach to medical management. Therefore, although they may perform separate functions, the Personal Health Nurse (PHN) and Utilization Management Utilization Management Nurse (UMN) work within a team to move the participant 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, that is assesses the participant, works with the participant, family and physician to identify problems, establish goals and develop plans of care, coordinates services, educates participants, empowers participants to independently self-manage and to make knowledgeable health care decisions. The UMN provides utilization review/pre-certification or pre-notifications on various individuals under designated group health contracts. Both the PHN and UMN work closely with the provider(s) to ensure that services are provided in the most appropriate setting by the appropriate provider(s). Both perform some functions of Personal Health Management and Utilization Management. Additionally, they interface with clients and with IMMS account managers and are responsible for the medical management of designated account(s). Within this description, the title “Medical Management Nurse: refers to both. All Medical Management Nurses practice within the scope of their licensures.
EDUCATION / EXPERIENCE
Bachelors degree in a health related field, five (5) years of UM/CM experience, and CCM preferred. Registered Nurse license and three to five (3-5) years of diverse clinical experience required.
InforMed Med Mgmt Services