Remote Risk Management Jobs in Hartford, WI (NOW HIRING)

Remote Per Diem position with availability Monday - Friday 8am-6pm. Weekend and Holiday rotations required.

Must be able to work 32-40 hours per week for orientation for the first 2-3 months of employment.

Pay Range

Major Responsibilities:

• Responsible for the screening and accurate completion of all referrals to ensure patients meet agency admission criteria and comply with State and Federal Regulations
• Provides quality customer service, promoting collaboration and coordination with referral sources and home care for smooth transition of patient to appropriate next level of care.
• Maintains clinical skills and competency by attending assigned training. Adapts to changing business needs, conditions and work responsibilities.
• Responds to inquiries regarding Advocate/Aurora Health at Home services and programs. Explains programs and services, in addition to determining if patients meet criteria for Centers for Medicare & Medicaid Services (CMS) certified agency, admission policies and/or referring requests to other community agencies when appropriate.
• Identifies risk management situations and completes high risk referral process on all appropriate patients based on established guidelines.
• Interprets company services, admission criteria and medical policies to referral sources and individuals seeking information.
• Documents the initial plan of home health care and initiates interdisciplinary communication.
• Interacts with patients/families, physicians and referral sources telephonically to assess and evaluate patient for home care appropriateness.
• Acts as a resource to physicians, physician offices, patients and families, hospital and designated skilled nursing facility staff (i.e. care management, discharge planners, social workers, nursing) regarding types of services available and the criteria for home care, including Medicare guidelines. Maintains knowledge of agency payors: Medicare, Medicaid and contracted commercial insurance reimbursement guidelines.
• Provides education to care team as requested on services that may enhance the transition of care for patients including DME, Hospice, Palliative Care, Pediatrics and Home Infusion Therapy. May participate in precepting new hire training and orientation
• Provides suggestions or improvements in current practices (i.e. process, documentation, etc.) to improve quality, productivity and customer satisfaction.
• Performs other duties and responsibilities as assigned.

Licensure, Registration, and/or Certification Required:

• Registered Nurse - License issued by the state in which the team member practices.

Education Required:

• Min ADN, BSN Preferred

Experience Required:

• Typically requires 2 years of experience in clinical nursing. Home Care/Intake experience preferred

Knowledge, Skills & Abilities Required:

• Computer technology skills
• Excellent interpersonal and critical thinking skills necessary to interact with both internal and external clients.
• Strong verbal and written communication skills
• Ability to adapt to a changing environment
• Must be detail-oriented and have excellent organizational skills
• May include weekend, holiday and on-call rotation
• Other duties as assigned.

Physical Requirements and Working Conditions:

• Generally exposed to a normal office environment.
• Must be able to sit for extended periods and may be required to stand, bend, twist, kneel, squat and reach above the shoulders throughout the workday.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our CommitmenttoYou:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

• Premium pay such as shift, on call, and more based on a teammate's job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical, dental, vision, life, andShort- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.