Primary City/State:

Mesa, Arizona

Department Name:

Banner Staffing Services-AZ

Work Shift:

Day

Job Category:

Clinical Care

Banner Health invests in our nurses by training them to confidently and safely deliver excellent patient care. Banner Health is committed to developing the careers of our team members. We care about you, your nursing career today and your future. Great options and great opportunities.

POSITION SUMMARY
This position provides comprehensive care coordination for members as assigned. This position assesses member’s needs to identify possible gaps in care. This position assists in facilitating provider engagement to address services to meet the member’s needs. The intensity of care coordination provided is situational and appropriate based on patient need and payer requirements. This position is accountable for the quality of clinical services delivered by both them and others and identifies/resolves barriers which may hinder effective member care.

CORE FUNCTIONS
1. Manages individual members/patients across the health care continuum to achieve the optimal clinical, financial, operational and satisfaction outcomes.

2. Acts in a leadership function with process improvement activities for populations of patients/members to achieve the optimal clinical, financial, operational, and satisfaction outcomes.

3. Evaluates the appropriateness of care, optimizing patient outcomes.

4. Establishes and promotes a collaborative relationship with providers, other payers, and other members of the health care team. Collects and communicates pertinent, timely information to fulfill utilization and regulatory requirements.

5. Acts in a leadership function to collaboratively develop and manage the interdisciplinary member discharge plan. Effectively communicates the plan across the continuum of care.

6. Educates internal members of the health care team on care management and managed care concepts. Facilitates integration of concepts into daily practice.

7. Has freedom to determine how to best accomplish functions within established procedures. Confers with supervisor on any unusual situations. Positions are facility based with no budgetary responsibility. Internal customers: All levels of health plan staff and members of the interdisciplinary health care team. External Customers: Physicians and their office staff, other payers, community agencies, provider networks, and regulatory agencies.

MINIMUM QUALIFICATIONS

Requires bachelor’s degree in social work or related field or equivalent experience.

Requires a proficiency level typically achieved with five years experience. Must have a working knowledge of care management, hospital and community resources. Must demonstrate critical thinking skills, problem-solving abilities, effective communication skills, and time management skills. Must demonstrate ability to work effectively in an interdisciplinary team format.

Employees working at Banner Behavioral Health Hospital or BTMC Behavioral must possess an Arizona Fingerprint Clearance Care at the time of hire and maintain the card for the duration of their employment.

PREFERRED QUALIFICATIONS

Additional related education and/or experience preferred.

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

Privacy Policy:

Privacy Policy