Utilize Health is a care management company whose mission is to improve the health and well-being of people with neurological conditions. Our specialized care management program offers a better way to manage brain injury, stroke, and spinal cord injury diagnoses allowing for better continuity of care and reduction of avoidable high-cost services. Utilize Health's Care Managers and Nurses support members as an advocate through their healthcare journey, assisting them with physical, behavioral, functional, preventative and social determinants of health needs.

JOB OVERVIEW

The Clinical Quality Nurse Manager is responsible for ensuring quality throughout the Utilize Health patient journey. The Clinical Quality Nurse Manager collaborates with care managers to ensure optimal quality patient care coordination activities. The Clinical Quality Nurse Manager is responsible for monitoring and intervening to meet patient care measures including gaps in care, hospitalizations, and other clinical indicators aimed at improving health. The Clinical Quality Nurse Manager responds to clinical escalations from the care management team, creates and reviews comprehensive care plans, and overcomes barriers to care. The Clinical Quality Nurse Manager assumes responsibility for assisting patients with navigating the healthcare system, providing patient and family education that supports self-management and reduces complications & sequelae, and interventions that address social determinates of health. The Clinical Quality Nurse Manager acts as a patient advocate in supporting factors that impact customer satisfaction and overall health outcomes.

JOB RESPONSIBILITIES

Member of the Utilize Health multidisciplinary care coordination team, serving as an advocate and educator.
Provide care coordination, health promotion, care planning and transitional care activities.
Improve outcomes by reducing hospital and emergency room admission, closing gaps in care, and actively coordinating care of individuals with a diagnosis of stroke, spinal cord injury or brain injury.
Accurately tracks quality measures and intervenes when there is an opportunity to improve.
Coordinate care and manage quality measures ensuring Utilize Health program goals are met.
Perform care coordination activities to include continual assessments of patients’ physical and behavioral health needs, interventions, patient education and development of an individualized care plan with measurable goals that ensure needs are met.
Ensure patient’s daily medical, behavioral, and environmental needs are planned for and coordinated.
Demonstrate knowledge of community and care resources.
Participate in identification & enrollment of appropriate patients.
Participate in care team huddles, clinical case reviews, triages and warm handoffs.
Support patient access to care by serving as a liaison between the patient and care providers such as PCPs and specialists.
Assists in the development and dissemination of patient education including patient action plans.
Assists in transitions of care from hospital, acute rehab, or other inpatient care settings to home.
Ensure timely and appropriate documentation in the Electronic Health Record.

OTHER RESPONSIBILITIES

Must maintain an active Tennessee Registered Nurse License.
Responsible for attending all in-services, continuing education and annual health requirements.
Comply with all OSHA and safety policies, practices, and procedures. Report all unsafe practices or accidents to supervisor.
Will be compliant with the relevant regulations concerning the privacy and security of patient’s protected health information (PHI) as established by the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Perform other duties as assigned.

MINIMUM QUALIFICATIONS

Graduated from an accredited Registered Nurse Program.
Compact or State of Tennessee Active Registered Nurse Licensure.
American Heart Association’s BLS certification for HealthCare Providers required upon hire.
Two years of experience in clinical quality preferred. Case management or home health experience preferred.
Neurological care experience.
Ability to travel.
Passion for working with the neurological population.
Demonstrated ability to provide care coordination.
Proficient in documenting care coordination activities in an electronic medical record.
Excellent oral and written communication skills.
Proficient in Microsoft Office Suite.

APPLY

To apply, send a cover letter and resume to careers@utilizehealth.com.

Pre-employment screening required including background check and drug screening test. Utilize Health is a proud Equal Employment Opportunity employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

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