- This position is completely telephonic in a call center environment
- Goals of the program include providing a one-time outreach to members for follow up post HouseCalls visit to provide education and clarification on any concerns raised during their HouseCalls visit
- The main objective of this program is to ensure successful transition of care from the HouseCalls Advanced Practice Clinician back to the members Primary Care Provider
- The Nurse Care Manager (NCM) will report directly to the Manager/or Director of Clinical Operations of HCCST
The NCM interacts via telephonic consult with members and providers to assist with education and clarification on any concerns raised during the HouseCalls visit and ensure the member has/or assist in obtaining an appointment with the provider to transition care They work to ensure members receive quality customer service by answering questions, addressing concerns, providing education, providing resource information, and entering referrals *The schedule is Monday through Friday from 9AM to 5:30PM Eastern or 9AM to 5:30PM Central respectively.**
- Perform telephonic outreach to members identified by the Advance Practice Clinician for specific referral related issues
- Ensure member has scheduled appointment with Primary Care Provider (PCP)/specialty provider; help scheduling appointment, if needed
- Refer members to internal departments such as Social Work, or Clinical Help Desk when appropriate
- Gather clinical information telephonically from patient/family
- Assist patients/members with urgent needs requiring acute intervention that arise during the call
- Identify triggers for hospitalization and barriers to meeting healthcare goals as they arise during the call
- Complete required documentation in compliance with auditing standards and policies
- Provide patient/family education on disease process and trigger management that arise during the call or are directly related to referral reasons
- Assist with connections to appropriate community resources if needed
- Understand and maintain confidentiality of legal and ethical issues
- Maintain compliance with all HIPAA (Health Insurance Portability and Accountability Act) regulations
- Enhance the experience of both internal and external customers by providing excellent customer service while maintaining production metrics
- Serve as a clinical resource and consultant for other clinicians
- Attend and participate in team huddles and staff meetings
- Work with Supervisor to identify system improvements that could be made to drive operational advancements and efficiencies
- Provide cross-coverage support across the team and assist with special projects, as needed
- Assume other duties as assigned and directed by the Supervisor or Manager of Clinical Call Center Operations
- You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in
- This important preventive care helps identify and reduce health risks for patients, in addition to coordinating appropriate follow-up care to improve health and well-being
- The HouseCalls Clinical Support Team (HCCST) supports Advanced Practice Clinicians in the HouseCalls program by providing telephonic consultation to plan members post HouseCalls visit
