DescriptionISTA Solutions, an outsourcing/offshoring company, is in search of an experienced PHRN/USRN to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you!
Job Description:
- Manage high-risk and rising-risk patient registry
- Oversee systems for identifying high risk patients through EMR, Care Management Systems, referrals, registries from health insurance payers
- Ensure validity of registry; collaborate with Information Technology on registry functionality
- Act as clinical liaison for health insurance Based Care Management programs, including ACO, commercial payors, Medicare advantage, managed care and Medicaid as indicated.
- Conduct data reporting to identify gaps in care or services and conducts patient outreach to facilitate follow-up care or services.
- Communicate and coordinate with medical and mental health providers concerning options, including community services; available to the patients they serve.
- Interface with and refer patients to other supportive services as appropriate.
- Serve as a linkage between Physicians and Providers that is involved in the care plan of the patient, focusing on improving coordination of services and information flow between the clinical team members.
- Provide self-management support to patients. Work to educate, motivate and coach patients utilizing disease-specific protocols.
- Provide patient education sessions for various chronic health conditions, e.g., diabetes, CHF, COPD, etc.
- Provide ongoing phone contact with patients.
Requirements - Must have an active PHRN license (USRN license is a PLUS)
- With 1 -2 years experience in the BPO industry
- Has a good working knowledge with US Healthcare practices and regulations
- Good working knowledge with Clinical Appeals and Revenue Cycle Management is a PLUS
- Bilingual proficiency in Spanish and English
- Amenable working night shifts
BenefitsWhat can we offer you?
- Competitive salary and benefits
- Health Insurance with free dependents*
- 10%-night differential
- Attendance Bonus
- Paid time off
- Convertible to cash leave credits
- Performance Appraisal
- Work-life balance
- A focus on growing your career path with us
- We encourage you to follow your passions and learn new skills
Our commitment to you
- Strong culture and values-driven leadership
- We create opportunities for you to learn and grow at any stage of your career
- Continuous learning and innovation
- We foster an all inclusive environment where everyone thrives