We're much more than a health insurance company.

Amerigroup is the country's leading publicly traded company dedicated exclusively to the financially vulnerable, seniors and people with disabilities using publicly funded health care programs.

We serve approximately 1.8 million members in 11 states, and we employ about 600 doctors, nurses and social workers to serve our members and help ensure the best care possible.

The Case Manager RN manages members experiencing complex or catastrophic illness, injury or special conditions such as diabetes, HIV, transplant and so forth to insure cost effective and efficient utilization of health services. The manager is a member advocate who seeks and coordinates creative solutions to members' health care needs without compromising quality of outcomes.

PRIMARY RESPONSIBILITIES:

1. Obtaining accurate member histories.
2. Assessing clinical information to develop care plans including a member support system.
3. Establishing short- and long-term goals in collaboration with members that meet their needs and the referral source's requirements.
4. Establishing working relationships with referral sources and community resources.
5. Communicating care objectives to appropriate individuals/departments/referral sources.
6. Assessing biopsychosocial factors.
7. Identifying members with potential for high-risk complications and coordinating the appropriate treatment in conjunction with the member and the health care team.
8. Collaborating with the members' PCP and specialists in the development of the plan of care to ensure that physical needs are addressed.

EDUCATION AND EXPERIENCE:
Required: Current RN state license, four years experience in health care, case management, discharge planning or behavioral health, valid driver's license and access to a motor vehicle.

• Computer literate.
• Excellent verbal and written communications skills.
• Strong decision making skills.
• Ability to provide services in an environment that involves multiple health care systems.
• Ability to interact with all relevant components of the health care system.
• Ability to provide services that deal with the individual's broad spectrum of needs.
• Self-starter with ability to handle multiple projects at one time.
• Appreciation of cultural diversity and sensitivity towards target population.

Preferred: Bachelor's or Master's degree, experience working on the community level and with community agencies, bilingual a plus.

For further details or to apply visit: http://www.amerigroup-jobs.com/go/Cincinnati-Healthcare-Jobs/168930/

Background Investigation Required. AMERIGROUP Community Care is an Equal Opportunity Employer/Drug-Free Workplace. M/F/V/D

AMERIGROUP Community Care Live Well * Viva Bien

Two for Hospital Director of Case Management are available!. The first is for a large hospital (400 + beds) in the SW region of the country and they are looking for a Masters prepared RN with large hospital experience. This is a newly created position as the Director of Quality could not handle both. Salary range midpoint is $110k but can go higher for the right candidate. Reports to CNO. Oversees 4. Also oversees UR. 5 years Management experience in an acute care hospital in Case management a must. CCM required. All relocation and benefits. The second position is in Florida (north central) involves oversight of Case Management and Quality Management. Prefer masters 3 years minimum experience in hospital Case Management and Quality Management ; MUST BE RN Salary range to $90k + relocation. 100-200 bed hospital background preferred. $$$ FOR SUCCESSFUL REFERRALS . Thanks so much for your help.

Best regards,
Joy Ross
Executive Recruiter
ALL MEDICAL SEARCH a division of ALL MEDICAL PERSONNEL
P 954-927-2800 X 5121
P 800-706-2378 X 5121
F 954-927-0590
JoyR@allmedstaffing.com

WellStar Health System, in Marietta, Georgia (www.wellstar.org) has retained The Gammill Group to conduct an executive search for a Director of Care Coordination for WellStar Cobb Hospital.

WellStar Health System is an integrated delivery system that includes five (5) hospitals (approximately 1300 beds), and a 400+ member multi-specialty employed physician group that practices out of sixty + sites throughout their service area. WellStar has an employee population exceeding 11,000 and net revenues in excess of $ 1.3 billion.

WellStar Health System has been going through a significant positive transformation over the past few years, and this will continue. A new leadership team is being built and they are fully committed to building toward being a "world-class" provider in healthcare. Common characteristics that exist within each new leader include:

• Will have a very participative and collaborative style. An engaging personality. Excellent relationship building skills.
• Leads by example. Has very high expectations. Wants accountability. Fosters accountability "on the ground" not just at the top.
• Wants a culture of "We" not "I". No hidden or personal agendas. No silos or turf issues.
• Highest levels of integrity and values.
• A sense of humor. A sense of urgency and also patience.
• Solution oriented. Results oriented.
• The passion and perseverance to build something great.
• Build leaders, not order takers. Enjoys coaching/mentoring/and developing others.
• Is a change agent. Is comfortable, experienced, and embraces leading and affecting change.

The Director will oversee the Case Management Department including monitoring the work of the Case Managers to assure that the following functions are completed: Utilization Review for medical necessity of admission and concurrent stay, Social Services Intervention, Discharge Planning, Resource Management, Concurrent Analysis, Delay in Services and Quality Concerns. This Director will also be responsible for the appeals process regarding denials of hospitalization. He/she will also be responsible for the analysis of data and reporting of monthly statistics and tracking logs. The Director will report to the Vice President of Medical Affairs.

This is a tremendous opportunity to be involved in taking a quality organization to a much higher level. It will require significant energy and commitment however will make a lasting imprint.

If you possess the necessary experience and qualities and want to know more, we would look forward to speaking with you (in confidence) and sharing more about this great transformation. If you know of others who should know about this opportunity, please forward this information to them.

We help leaders have the opportunity to lead!

Interested parties should reply in confidence to either:

Steven L. Grace, Partner                       Jim Passias, DO, Director, Clinical Search Practice
Phone:  (614) 848-7726 x 1015               Phone:  (614) 848-7726 x 1023
sgrace@gammillgroup.com                     jpassias@gammillgroup.com

Specialty Nurse-RightSource Specialty
Full Time Regular
posted 04/21/2010
OH - Cincinnati
Cincinnati, OH  

Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals. Today, Humana is a leader in consumer engagement. Throughout its diversified customer portfolio, the company provides guidance that can both help lower costs and lead to a better health plan experience.

Role: Specialty Nurse, RN Assignment: Rightsource Specialty Location: Cincinnati, OH

Are you a fit?
Do you enjoy working telephonically with patients? Do you have a desire to be in a position where you can provide guidance to our members and their health care needs? If so then read on!

Are you a fit?
As a Specialty Nurse you will:

• Support members telephonically and utilize clinical skills to assess and monitor specialty drug usage, adherence, and compliance to facilitate appropriate healthcare outcomes for members
• Educate members on specialty drugs and side effects
• Assess member's knowledge of condition(s) and educate with the goal of improving health
• Conduct individualized clinical assessments of member care needs and develops a personalized plan of care
• Reinforce appropriate self-care teaching, monitoring, and provides up-to-date health care information to facilitate the members understanding of health conditions
• Empower members to be their own advocate and actively participate with their provider in health care decision-making
• Assess and refer members to other Humana services and programs that may meet their needs
• Ensure accurate and complete documentation of required information in a clinical software platform(s)

Key Competencies

• Leveraging Technology: You are technological savvy and know how to appropriately share and use your knowledge to improve business results.
• Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.
• Is Accountable: You meet clearly stated expectations and take responsibility for achieving results.
• Clinical Knowledge: You understand clinical program design, implementation, management/monitoring to support choice in consumer medical care. Understands the medical utilization implications of such programs
• Communication: You actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience.

Role Essentials

• Active RN license in Kentucky or Ohio and possess the ability to be licensed in multiple states without restrictions
• Must be willing to work 11:30am-8pm M-F
• 3-5 years of Nursing Experience
• Excellent communication skills
• Ability to work independently under general instructions and with a team
• Strong computer and web navigation skills
• Ability to be flexible and adapt to changing processes

Role Desirables

• Bachelor's degree, preferably in nursing/healthcare
• SPECIALTY PHARMACY experience
• Experience in providing telephonic care
• Certifications or advanced training in any of the following: MS, RA, Hepatitis C or Oncology
• Experience in disease management/health coaching and/or case management
• Health Plan experience
• Previous Medicare Experience
• Call center or triage experience
• Bilingual is a plus!!

Reporting Relationships
You will report to a Supervisor. This area is under the leadership of the SVP & Chief Operating Officer.

Kathleen Berrier
Team Leader - Talent Acquisition
Human Resources
W: (502)580-3988
C: (502) 767-4226

DCH Health System is a four-hospital system that includes DCH Regional Medical Center, the cornerstone of the DCH System with 583 beds; Northport Hospital-DCH, a 204-bed facility with 94 acute beds, a 54-bed psychiatric unit, and a 50-bed rehabilitation unit; Fayette Medical Center, a 61-bed, rural, acute care facility with a 122-bed SNF; and Pickens County Medical Center, which is a 56-bed, county-owned hospital. DCH Regional Medical Center was founded in 1923 as a 50-bed facility. It is now the fourth largest hospital in Alabama and is a member of VHA.

DCH was recently recognized by Case in Point magazine for their Hospital Case Management Program. The Platinum Award winners (DCH received honorable mention as a finalist) are the "most successful and innovative case management programs working to improve heath care across the continuum." DCH has one of the best hospital case management programs, working collaboratively with patients and the health care team to ensure patients receive safe, quality, evidenced-based care in the least restrictive setting.

Tuscaloosa, Alabama, is approximately 60 miles west of Birmingham on I-20. Tuscaloosa has a population of approximately 81,000, and the county has over 171,000 residents. Cost of living is reasonable, and the educational system is excellent, including two public school systems and six private schools. Additionally, there are three colleges/universities, including the main campus of the University of Alabama, which serves over 25,000 students.

Tuscaloosa is a growing community with strong economy in manufacturing and retail trade and is becoming an international player. The growing manufacturing community includes: Mercedes-Benz US International, JVC America, Phifer Wire Products, Johnson Controls, Uniroyal-Goodrich Tire Manufacturing (Michelin), Nucor Steel and many others. Tuscaloosa attracts investors and sells products on a worldwide scale.

Its abundance of natural resources provide low energy costs and excellent recreational facilities, which include Lake Tuscaloosa, a 5,885-acre lake surrounded by 1,613 acres of land, and is the home to one of the country's most elegant yacht clubs. There are a variety of restaurants, entertainment opportunities and festivals.

The Position: The Director of Case Management reports to the Vice President, Medical Affairs and is responsible for supporting operations of the department and providing leadership assistance and support to maintain department focus on reaching established goals.

The successful candidate should have the following knowledge, skills and experience:

• Minimum of 5 years clinical experience, predominately in the acute care setting preferred.
• Case Management experience required
• Ability problem solve in a proactive, creative manner, using sound judgment based of actual information and clinical knowledge. Must have excellent leadership skills
• At least 5 years supervisory/management experience required
• Ability to lead and actively participate in multidisciplinary teams
• Excellent computer skills
• Proficient in MS office products, MS Outlook, and Internet experience required
• SQL database experience preferred
• Meditech experience required
• Ability t
• work independently or within a team structure
• Excellent interpersonal skills and communication style
• Must be able t
• read, write, and speak English
• Must have knowledge of Medicare compliance issues
• Be a graduate of an accredited school of nursing Bachelor's and/or Master's degree in nursing, case management, health administration, public health, or business administration preferred

This search is being conducted by Garrett Associates Inc. For additional information please contact Chris Martin at Garrett Associates -- cmartin@gaisearch.com or 706-534-9270

Location: Southwest Ohio and Northern Kentucky

Grand Assistance Senior Home Care is a privately owned Home Care Agency founded in Cincinnati Ohio. We are focused on organic growth through Care Director Partnerships. We seek self driven entrepreneurial partners who have the desire and ability to develop and manage a select group of Private Duty Clients and Care Givers.

Our Care Directors have full administrative support from our primary office in Cincinnati and work remotely to deliver guaranteed five star client services. Care Directors do whatever it takes to deliver client satisfaction and support to our Caregivers. Care Directors travel to Clients homes and referral sources in a county wide area. Grand Assistance believes in pay for performance. This is a commission based position with substantial income potential.

The duties of a Grand Assistance Care Director may include, but are not limited to the following:

• Business Development
• Develop and maintain relationships with physicians, discharge planners, case managers, social workers, business leaders and other referral sources.
• Represent Grand Assistance at Networking Events, health fairs, Chamber of Commerce meetings and community functions.
• Client Relations
• Meet with potential Clients and their Family to: determine their care needs, create a plan of care, outline their schedule, review our Client Agreement and suggest an appropriate Grand Assistant.
• Proactively monitor care quality and client satisfaction with non-scheduled on-site client visits.
• Communicate with Client or the Clients Family and revise their care plan accordingly.

MORE INFORMATION