WellSky

Compensation

Full Description

The Clinical Operations Nurse is responsible for completing telephonic patient evaluations and assessments for WellSky's various payer programs. We invite you to apply today and join us in shaping the future of healthcare! Key Responsibilities Cultivate and maintain professional relationships with clients, patients, and stakeholders by providing sensitive and respectful care in line with diversity standards and human dignity. Conduct assessments with patients and providers to identify most appropriate level of care setting, identify potential gaps in care, and coordinate with stakeholders to provide resources to promote best possible outcomes and reduce readmissions. Coordinate and educate program expectations with providers, payers, and members to ensure appropriate referrals and optimized clinical outcomes. Advocate for patient needs through effective communication and service coordination and promote patient self-management and wellness by empowering patients and families to make informed choices and build supportive care systems. Collaborate with case managers, physicians, and medical directors to ensure appropriate levels of care and seamless care transitions. Responsible for making outreaches to emergency departments to provide care coordination and safe transitions for patients. Maintain accurate documentation, stay current on healthcare regulations and practices, and participate in team meetings and orientation activities to promote collaboration and continuous improvement. Perform other job duties as assigned. Required qualifications Bachelor’s degree or equivalent work experience. At least 2-4 years of relevant work experience. RN Licensure in New York and/or Oklahoma and/or Compact. At least 2 years’ experience in emergency departments. Preferred qualifications Experience in acute/ACO/post-acute care facility care coordination, discharge planning, social services, disease management, population health, home health, and/or post-acute care facilities. Job Expectations Willing to travel up to 30% based on business needs. Willing to work additional or irregular hours as needed/evening hours/holidays. Must work in accordance with applicable security policies and procedures to safeguard company and client information. Must be able to sit and view a computer screen for extended periods of time. #LI-PG1 #LI-Remote WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference. WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace. Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates. Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky: Excellent medical, dental, and vision benefits Mental health benefits through TelaDoc Prescription drug coverage Generous paid time off, plus 13 paid holidays Paid parental leave 100% vested 401(K) retirement plans Educational assistance up to $2500 per year WellSky is a technology company leading the movement for intelligent, coordinated care worldwide. Our next-level software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations solve tough challenges, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care.