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Care Manager - RN, Chronic Pain Management (Harrisburg, PA)

Company: Magellan Health
Location: Harrisburg
Posted on: September 11, 2018

Job Description:

Responsible for the assessment, reassessment, care planning and coordination of care and services for members enrolled in the Chronic Pain Management Program. Includes ongoing monitoring of an appropriate and effective person centered care plan, member education and care management. Regularly communicates with the member's Primary Care Physician (PCP) and other providers, and integrates the member, caregiver and other provider feedback into the assessment and planning.

  • Completes relevant screening and assessment tools to determine member readiness, level of risk and need for chronic pain case management.
  • Develops, implements and monitors the individualized Chronic Pain Plan, with specific, quantifiable goals and desired outcomes for members who meet criteria for intensive chronic pain case management.
  • Manages case load, including risk stratification of members, monitoring reassessment needs and facilitating linkage with appropriate services and resources when the member's level of chronic pain risk/need changes.
  • Serves as the primary point of member contact. Assesses member needs, manages care and services, and ensures effective communication among members, caregivers, providers and community supports.
  • Provides members with information and referral for alternative and complementary care, as needed and as provided in the member's benefit plan.
  • Follows guidelines of the Chronic Pain Case Management Program with respect to engagement, enrollment, case management activities, and discharge.
  • Maintains timely, complete and accurate documentation using both hard copy and technology-based solutions in compliance with regulatory policies and procedures.
  • Gathers and summarizes data for reports.
  • Supports initiatives of the Quality Assessment and Performance Improvement Committee.
  • Other duties as assigned. General Job Information Title Care Manager - RN, Chronic Pain Management (Harrisburg, PA)Grade23 Job Family Clinical Services Group Country United States of America FLSA Status United States of America (Exempt) Recruiting Start Date 8/29/2018 Date Requisition Created 8/29/2018 Minimum Qualifications Education Associates Nursing--&& Bachelors Nursing License and Certifications - Required PMC - Pain Management Certification - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt License and Certifications - Preferred CCM - Certified Case Manager - Care Mgmt, CCP - Chronic Care Professional - Care Mgmt Other Job Requirements Responsibilities
    • Integrated medical and behavioral health experience preferred, including appropriate support services in the community and accessing alternative and complementary services, such as acupuncture, chiropractic, and therapeutic massage.
    • Experience in utilization review, concurrent review and/or risk management a plus.
    • Bi/Multilingual.
      • Minimum 3 years clinical experience with focus in managed care, including chronic pain management and medical/mental health issues associated with chronic pain.
      • Pain Management Certification (PMC) must be obtained within 2 years of hire date.
      • Understands and is able to apply principals of Care Management and Person Centered Service Planning.
      • Ability to apply Chronic Pain Management Program guidelines.
      • Ability to understand and apply coverage guidelines and benefit limitations.
      • Familiar with clinical needs and disease processes for chronic pain and co-occurring physical and behavioral illnesses.
      • Understands and adapts appropriately to issues related to communication, cognitive or other barriers.
      • Experience and ability to use Motivational Interviewing best practice approach.
      • Ability to lead an interdisciplinary care team.
      • Strong organizational skills and the ability to prioritize and follow through on multiple projects in a timely manner. Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled

        Keywords: Magellan Health, Harrisburg , Care Manager - RN, Chronic Pain Management (Harrisburg, PA), Executive , Harrisburg, Pennsylvania

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