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Registered Nurse Care Manager - Managed Care
BJC HealthCare
Additional Information About the Role Join BJC Health System in providing RN care management for direct employer sponsored health plans with BJC.
Actively manage and outreach employer population being a resource to ensure care is being managed effectively and appropriately for conditions. You will also work off-site to support biometric screenings at various job sites and follow up on biometric screening for patients with emergent or critical values.
Schedule
Overview BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.
BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.
BJC’s patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children’s Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country.
The BJC Managed Care department includes multiple functions such as managed care contracting, financial analysis, systems and operations, value-based care and payment programs, payor and provider relations, and direct to employer solutions. Preferred Qualifications Role Purpose The Ambulatory Care Manager (RN) provides clinical care management services to identified eligible patients, coordinating care to obtain desired health outcomes, improving self-care abilities, and decreasing the unnecessary cost of care. This position performs standardized comprehensive needs assessment, identifying and addressing barriers to care and aligning patients with available benefits and resources. This position also collaborates with the patient, the provider and the care team to develop and implement a plan of care to ensure medically appropriate cost-effective care.
Responsibilities Minimum Requirements Education Experience Licenses & Certifications Preferred Requirements Education Benefits and Legal Statement BJC Total Rewards At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.
To learn more, go to www.bjctotalrewards.com/Benefits *Not all benefits apply to all jobs The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer
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