Opportunities

Department:

Disease Management

Job Summary:

Responsible for telephonic professional nurse coaching and education with consumers designated as at-risk. Promote preventive health, compliance with medical treatment plan, lifestyle modifications, self-management, and increased participation in decision-making regarding personal health and healthcare.

Key Job Responsibilities:

Duties may include, but are not limited to all or some of the following:

• Establish professional phone relationship with clients to increase compliance, self management and participation in personal health and health care decision-making.
• Manage case load as assigned
• Contact consumers within designated time frames
• Communicate consumer rights and responsibilities in the Disease Management program upon enrollment; Perform interactive assessments and periodic re-assessments with consumer.
• Develop disease management care plans with goals that support consumer self-management and decision-making.
• Provide consumer education and coaching related to specified disease using approved evidence-based clinical guidelines and appropriate approved decision-support tools where available
• Coordinate care with appropriate internal and external resources
• Enter consumer data in electronic medical record, including assessments, goals, and care provided
• Ensure compliance with quality patient care and regulatory compliance within the company’s standards and RN scope of practice.
• Send letters and educational information to consumers as needed.
• Other duties as assigned.

Job Qualifications:

Education:

• BSN preferred
• ADN or Diploma required.
• RN, active nursing license in state of practice required.
• Patient education experience preferred

Required Skills:

• Pleasant voice quality
• Excellent phone, verbal and written communication skills required to meet superior customer service and satisfaction levels
• Ability to function as member of a multi-disciplinary team
• Ability to communicate, read and write fluently in English
• Self motivated
• Proficient knowledge of computer/word processing skills
• Flexibility
• Excellent customer service skills

Accountability:

• Ability to manage assigned case load as business needs dictate.
• Excellent time management, flexibility, and efficient organizational skills with ability to work independently and as a team player
• Adherence to legal and ethical principles of privacy, confidentiality, safety, advocacy, and accreditation and regulatory standards as established by department
• Ability to comply to internal and external goals/metrics established for assigned department

Location:

Remote position

To apply email your resume to resume@inventivmm.com.

Department:  

Information Technology

Job Summary:

Leads full lifecycle of software development initiatives including the gathering of business requirements, authoring of functional requirements, definition of system architecture and software design, and construction, testing, deployment, and support of the solution. Provides direction to software programmers to construct, test, deploy and support components of the solution.

Key Job Responsibilities:

Duties may include, but not limited to all or some of the following:

• Foster an agile development environment by applying the right amount of rigor for the task at hand while balancing aggressive timelines.
• Provide guidance and visibility throughout the software lifecycle to non-technical stakeholders to instill confidence and credibility in the process and end product.
• Thoroughly understand the business through interviews, research, time-motion studies, etc.
• Champion the business requirements process through interviews, chairing requirements gathering sessions, documenting findings including workflows / swim lane diagrams, and reviewing with stakeholders to ensure a common understanding. Create prototypes where feasible to assist in the requirements analysis process.
• Author functional requirements for software development to meet business objectives and requirements.
• Create the system architecture and software design to fully support business and functional requirements.
• Construct the software including coding and unit test.
• Deploy and support the software in various environments including UAT (user acceptance test), demo, staging, and production.
• Provides direction to 1-3 software programmers to construct, test, deploy and support components of the solution.
• Improves operations by conducting systems analysis; recommending changes in policies and procedures.
• Obtains and licenses software by obtaining required information from vendors; recommending purchases; testing and approving products.
• Updates job knowledge by studying state-of-the-art development tools, regulatory and industry requirements, and software engineering techniques; participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.
• Protects operations by keeping information confidential.
• Assist in the maintenance of documentation relating to the various applications including user training manuals.
• Must be able to work as a team member.
• Perform other job-related duties as required

Job Qualifications

Education / Experience:

Education: A BS in information technology or related field required

Skills:

Required:

• High energy and self-motivated
• Organized and detail oriented, with good verbal and written communication skills
• 6+ years’ experience in software development with 4+ years using modern programming languages and frameworks such as C# / .NET or Java
• Strong knowledge of SQL
• Solid knowledge of web services and other web technologies such as AJAX, JavaScript
• Proven ability to deliver results on time in a fast-paced, high stakes environment working on project that make a difference
• Track record of being able to extract business requirements from unstructured environments and then construction IT solutions to satisfy those requirements
• Healthcare IT experience
• Proven experience with software development life cycle methodologies and processes
• Consistent work history

Preferred:

• Experience with Agile development methodologies
• EDI experience including 837 (claims), 834 (eligibility), or 835 (explanation of benefit)
• Service Oriented Architecture (SOA)

To apply send your resume to resume@inventivmm.com.

Job Summary:

Assist patients to achieve optimal health status utilizing the most cost effective quality resources through application of national practice guidelines and Case Management (CM) Standards of Practice.  Implement appropriate interventions to manage multiple physical, psychological, social and financial barriers in cooperation with patient, insurance carrier, and medical provider. 

Key Job Responsibilities:

Duties may include, but not limited to the following:

• Develop a case management care plan for each patient based on a thorough history and clinical record review, including the attending physician’s plan, the recommendations of national guidelines, in consideration of the patient’s ability to comply.
• Provide case management/utilization review and discharge planning to assure that the patient progresses through the continuum of care and is discharged utilizing the most cost effective quality resources through the application of national practice guidelines and CM Standards of Practice.
• Coordinate the integration of the social service function into patient care.
• Coordinate the hospital activities concerned with case management and discharge planning.
• Adhere to departmental goals, objectives, standards of performance, and policies and procedures.
• Ensure compliance with quality patient care and regulatory compliance within the company’s standards and RN scope of practice.
• Implementation of case management interventions by the application of methods, techniques, behaviors, information and learning aids that positively impact the patient and their condition.
• Organize, secure, integrate and modify the resources necessary to accomplish the goals outlined in the case management plan. Targeted utilization of inVentiv MM specialists and resources.
• Timely creation of quality case management reports documenting results of CM plan interventions in achieving patient-specific goals.
• Facilitation of benefits preservation through coordination of appropriate level of care and plan language compliance.
• Determining Medicare/Medicaid eligibility and/or availability of secondary insurance plan.
• Facilitation of recommended treatments with contracted vendors to preserve patient benefits and facilitate cost containment objectives.
• Comply with inVentiv confidentiality policy, HIPAA requirements and state and federal regulations.
• Function as an effective liaison between patient, third party payer, reinsurance carrier and/or other customers while implementing targeted interventions in keeping with plan language and limitations.
• Functions as a member of a multi-disciplinary team including social workers, dieticians, pharmacologist, and physician consultants.
• Act as a liaison to providers and community health resources.
• Provides focused education and emotional support regarding identified risk factors on a constant basis.
• Support the highest level of participant-defined quality of life and well-being.
• Work closely with participant to facilitate understanding of available client benefits and local and national resources.
• Business travel may be required. Multi-state licensure may be required.
• Ability to work in triage and/or disease management role if needed.
• Other duties as assigned.

Job Qualifications:

Education/Certification:

• Licensed Registered Nurse with current, unrestricted license in state of practice required.
• Nursing Diploma and/or college degree in nursing required. (eg: ADN or BSN).
• Minimum two years (full- time equivalent) direct clinical care experience required.
• Bachelors (or higher) degree preferred. Must be willing to obtain Bachelor’s degree with four years to complete.
• Certified Case Manager preferred – Mandatory to apply for CCM certification when eligible.
• Minimum three years industry experience in a managed care setting focused on experience in utilization review/case management and at least two years case management, home care or hospice experience strongly preferred.
• Minimum of Class B driver’s license preferred.

Required Skills:

• Ability to interact with a wide variety of people and handle complex situations simultaneously with customer service focus
• Evidence of creativity, integrity and initiative
• Attention to detail and follow-up.
• Experience with electronic clinical charting/records         
• Ability to work independently and be self-motivated in a remote environment
• Must practice case management within the scope of licensure (based on the standards of discipline) which includes the knowledge of healthcare benefits and health promotion.
• Manage assigned case load as business needs dictate.
• Excellent time management, flexibility, and efficient organizational skills with ability to work independently and as a team player in both office/remote environment
• Adherence to legal and ethical principles of privacy, confidentiality, safety, advocacy, and accreditation and
• regulatory standards in all case management activities in both office/remote environment
• Compliance to internal and external goals/metrics established for assigned department
• Position is often required to independently plan and prioritize patient care objectives.
• The ability to analyze and problem-solve

Technical Skills:

• Proficient computer skills in Windows and Internet use.
• Ability to chart and follow designated workflow(s) in an electronic environment.
• Proficient in typing

Communication Skills:

• Strong verbal and written communication skills required to meet superior customer service and satisfaction levels.
• Excellent interpersonal skills and ability to function as a member of a multi-disciplinary team.
• Ability to communicate, read, and write fluently in English
• Effective analytical and problem-solving skills.

To apply email your resume to resume@inventivmm.com.