Quantum Health
  • - Clinical Services
  • Columbus, OH, USA
  • Salary
  • Full Time

Job Title:  Personal Care Guide, Nurse Care Coordinator

Working Group: Clinical Operations

Reports to: POD Manager

Location & Hours: This position is located at our office in Columbus,OH. Hours are Mon-Fri 9a-6p, 10a-7p, or 11a-8p

Description: The Personal Care Guide Nurse is responsible for providing case management services for members of Quantum Health employer groups with catastrophic illnesses/ injuries, acute and chronic medical conditions. They also function as a clinical resource for other staff in the company such as Utilization Management, Patient Services, Client Services and Sales.

Role and Tasks:

  • Promote the mission and core values of Quantum Health
  • Identify members for specific case management and/or chronic condition management activities by utilizing established screening criteria
  • Apply the nursing process when actively managing members
  • Coordinate all services in an effort to provide integrated health services for each member
  • Provide benefit and health information to each member so they are able to make informed health decisions
  • Serve as member and provider advocate by educating and guiding through the complicated healthcare system
  • Assure quality of care by adhering to therapeutic standards; measuring health outcomes against member care goals and standards; making or recommending necessary adjustments; following hospital and nursing division's philosophies and standards of care set by state board of nursing, state nurse practice act, and other governing agency regulations.
  • Document all activities specific to members, caregivers, providers, facilities and clients in appropriate database
  • Maintain a collaborative relationship among health care teams by communicating information, responding to requests, building rapport, participating in team problem-solving methods
  • Assist members and clients with wellness activities, enhanced benefits, behavioral incentives
  • Maintain a working knowledge of all policies and procedures related to Clinical Operations
  • Maintain a working knowledge of employer health benefit plans and know where to access benefit information
  • Be a clinical resource for all Quantum Health work teams
  • Utilize well developed critical thinking and interpersonal skills to problem solve and make knowledgeable recommendations for needed actions

 Skills and Qualifications:

  • Unrestricted, active license as a Registered Nurse in the state of Ohio
  • BSN preferred
  • Minimum of two years clinical experience with direct patient care required
  • Possess excellent critical thinking skills
  • Certification in Case Management preferred
  • Strong customer service skills
  • Possess excellent verbal and written communication skills
  • Possess excellent time management skills
  • Ability to make decisions that are timely and achieve results consistent with the business goals and organizational culture
  • Ability to work independently with minimal supervision
  • Outstanding computer skills including Microsoft applications

 

Revised 1/9/2018

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