[Hiring] Personal Health Nurse @Conifer Health Solutions

Role Description

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
• Empower members to independently self-manage and 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 is responsible for the medical management of designated client(s). All Medical Management Nurses practice within the scope of their licensures.

Qualifications

• 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
• Excellent written communication skills
• 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

Requirements

• 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
• RN (Registered Nurse) license required
• Current active professional license in the state of residence
• Eligibility for unrestricted professional licenses in all states

Benefits

• Medical, dental, vision, disability, life, and business travel insurance
• Paid time off (vacation & sick leave) – min of 12 days per year, accrued 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

Company Description

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.