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RN Disease Management Coordinator
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RN Disease Management Coordinator

Job Description

Position Purpose
 

The Kentucky Health Cooperative (KYHC), based in Louisville, has created and operates a Consumer Oriented and Operated Plan, or CO-OP in the Commonwealth of Kentucky. The CO-OP is a non-profit and member-owned health insurance company. KYHC’s goal is to offer Individual and Small Employer Group commercial health plans for Kentucky residents in accordance with the Affordable Care Act (ACA). KYHC exists to promote community health and well-being by engaging the members and providers it serves in the valued delivery of quality coverage for integrated health care services. For more information on our organization, please visit www.mykyhc.org.

KYHC is seeking an RN Disease Management Coordinator to develop and implement Disease Management Program(s) for newly diagnosed and/or members with chronic disease conditions lacking knowledge and tools.The Disease Manager reports to the Director of Quality Improvement and is responsible in helping members to self-manage and to modify behavior of specific chronic conditions.


Duties/Responsibilities
 

  • Assesses the members’ knowledge and understanding of the self-management of chronic conditions and its severity, including the members’ motivational and self- confidence related to expected behavior change in order to develop a plan that will address those needs
  • Determines specific objectives, goals and actions as identified through the assessment process developed in collaboration with the member
  • Executes specific interventions and/or education that will lead to accomplishing the goals established
    • This will include instruction on how to self-manage his or her chronic condition and empowering members by using motivational interviewing techniques to promote self-advocacy
    • Educates members about their disease process and the importance of adhering to their medication regiment
  • Organizes, integrates and utilizes the resources necessary to accomplish the established goals
  • Conducts scheduled monitoring calls to ensure compliance of action plan in order to gather sufficient information to monitor the progress of meeting established goals
  • At appropriate and repeated intervals, determines the plan’s effectiveness in reaching desired outcomes and goals 
  • Compares the patient’s disease state to evidence based guidelines to determine variances and then intervene as indicated
  • Supports Quality Improvement initiatives related to disease management
  • Performs and/or assists in HEDIS medical record review
  • Provides support to the Case/UM Management Staff as needed
  • Other duties as assigned

Job Requirements

Skills/Competencies
 

  • Effective analytical, verbal and written communication skills
  • Ability to work independently and in a team environment
  • Ability to manage multiple tasks
  • Competent in the use of computer applications
  • Effective clinical judgment
  • Excellent organizational skills
  • Strong communication skills with demonstrated ability to educate individuals
  • Bilingual skills desirable, based on business needs


Knowledge/Experience
 

  • 3-5 years of related experience including, preventive care, diabetic education, homecare, critical care or public health
  • 5-7 years of health care related clinical experience (preferred)
  • Knowledge of Disease Management principles
  • Motivational Interviewing experience (preferred)
  • Work experience may be substituted for educational background (on a year for year basis) up to a maximum of two years)


Licenses/Certifications
 

  • Registered Nurse with current Kentucky license required
  • Bachelor’s degree in Nursing (preferred)

Job Snapshot

Employment Type Full-Time
Job Type Insurance, Health Care, Nonprofit - Social Services
Education Not Specified
Experience At least 3 year(s)
Manages Others Not Specified
Industry Insurance, Healthcare - Health Services, Not for Profit - Charitable
Required Travel Not Specified
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RN Disease Management Coordinator


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