Arkos Health

Manager

• Work directly as a member of the Arkos Health Interdisciplinary Team
• Implement and participate in the patient’s plan of care; update and revise as needed
• Assist in coordination of comprehensive care; including obtaining referrals to other interdisciplinary services (Home Health, Palliative Care, Social Services) to help prevent further need for acute care utilization
• Maintain case load based on the needs of the client and/or contractual obligation
• Conduct face to face visits at a minimum of every 2 weeks for assigned patients enrolled in Intensive Case Management. May conduct increased face to face or telephonic visits based on the needs of the patient and or contractual obligation
• Complete Clinical and Social Assessments (CSA) to develop care plan upon initial start of care visit with patient
• Provide communication with patient’s providers and medical specialists regarding patient status and any changes in condition
• Engage with Arkos Health leadership and contracted providers to resolve changes in patient status, complaints, or complications though participation in weekly ICT meetings
• Complete medical reconciliation for all transitional care patients within 30 days of initiation of TCM contact

RN Care Manager – Field-Based

• Work directly as a member of the Arkos Health Interdisciplinary Team
• Implement and participate in the patient’s plan of care; update and revise as needed
• Assist in coordination of comprehensive care; including obtaining referrals to other interdisciplinary services (Home Health, Palliative Care, Social Services) to help prevent further need for acute care utilization
• Maintain case load based on the needs of the client and/or contractual obligation
• Conduct face to face visits at a minimum of every 2 weeks for assigned patients enrolled in Intensive Case Management.
• May conduct increased face to face or telephonic visits based on the needs of the patient and or contractual obligation
• Complete Clinical and Social Assessments (CSA) to develop care plan upon initial start of care visit with patient
• Provide communication with patient’s providers and medical specialists regarding patient status and any changes in condition
• Engage with Arkos Health leadership and contracted providers to resolve changes in patient status, complaints, or complications though participation in weekly ICT meetings
• Complete medical reconciliation for all transitional care patients within 30 days of initiation of TCM contact

RN Care Manager

• Work directly as a member of the Arkos Health Interdisciplinary Team
• Implement and participate in the patient’s plan of care; update and revise as needed
• Assist in coordination of comprehensive care; including referrals to internal services (In Home Wellness, Social Services Care Management, Quality Coordination) and external interdisciplinary services to help prevent acute care utilization.
• Maintain case load based on the needs of the client and/or contractual obligation
• Conduct face to face visits at a minimum of every 2 weeks for assigned patients enrolled in Intensive Case Management.
• May conduct increased face to face or telephonic visits based on the needs of the patient and or contractual obligation
• Complete Clinical and Social Assessments (CSA) to develop care plan upon initial start of care visit with patient
• Provide communication with patient’s providers and medical specialists regarding patient status and any changes in condition
• Engage with Arkos Health leadership and contracted providers to resolve changes in patient status, complaints, or complications though participation in weekly ICT meetings
• Complete medical reconciliation for all transitional care patients within 30 days of initiation of TCM contact

RN Case Manager

• Provide oversight and direction to the STARS/HEDIS department
• Hold staff accountable to Departmental goals
• Schedule and follow up on clinical care needs for patients as it relates to Quality Data
• Manage staff in the STARS/HEDIS Department
• Assist staff in quality initiatives, including STAR initiatives
• Collect, report, and respond to metrics
• Contribute to the organization's drive to improve the overall experience of patient care
• Review and provide performance feedback to the STARS/HEDIS department
• Establish annual and monthly departmental and individual staff goals
• Ensure the training and on-boarding of new staff
• Provide day-to-day management of staff
• Perform quarterly performance reviews all Arkos Health STARS/HEDIS staff
• Provide education regarding STARS/HEDIS initiatives to staff and outside individuals
• Attend Arkos Health educational and demonstration activities
• Perform the duties of STARS/HEDIS team members, as needed
• Review data collected and to develop strategies to improve performance
• Implement strategies to improve department performance
• Create, maintain, and improve written department process flows and procedures
• Ensure gaps in care are captured
• Coordinate and order preventative and diagnostic tests around gaps in care on behalf of the primary care physician
• Conduct data entry and maintain appropriate documentation and tracking for quality initiatives
• Educate patients on procedures being performed

Quality Manager – STARS, HEDIS

• Provide oversight and direction to the STARS/HEDIS department
• Schedule and follow up on clinical care needs for patients as it relates to Quality Data
• Manage staff in the STARS/HEDIS Department and assist staff in quality initiatives
• Collect, report, and respond to metrics
• Review and provide performance feedback to the STARS/HEDIS department
• Establish annual and monthly departmental and individual staff goals
• Ensure the training and onboarding of new staff
• Perform quarterly performance reviews of all Arkos Health STARS/HEDIS staff
• Provide education regarding STARS/HEDIS initiatives to staff and outside individuals
• Attend Arkos Health educational and demonstration activities, as needed and directed by Executive Medical Director
• Review data collected and develop strategies to improve performance
• Implement strategies to improve department performance
• Create, maintain, and improve written department process flows and procedures to improve the functioning of the department
• Ensure gaps in care are captured and coordinate preventative and diagnostic tests around gaps in care
• Conduct data entry and maintain appropriate documentation and tracking for quality initiatives
• Educate patients on procedures that are being performed and the reason for performing them
• Collaborate with the PCP in the management and care coordination for members with open gaps of care
• Demonstrate the ability to work collaboratively, efficiently, and effectively as a high-performing quality team member
• Coordinate and participate in internal and external meetings
• Contribute as an active participant in quality initiatives
• Follow Arkos Health procedures, practices, policies, and guidelines to ensure the safety, security, and well-being of patients
• Perform other duties as assigned to support the overall effectiveness of the organization.

• Provide oversight and direction to the STARS/HEDIS department.
• Hold staff accountable to departmental goals.
• Schedule and follow up on clinical care needs for patients as it relates to Quality Data, including but not limited to Healthcare Effectiveness Data and Information Set (HEDIS).
• Manage staff in the STARS/HEDIS Department and assist staff in quality initiatives, including STAR initiatives.
• Collect, report, and respond to metrics and contribute to the organization's drive to improve the overall experience of patient care.
• Review and provide performance feedback to the STARS/HEDIS department.
• Establish annual and monthly departmental and individual staff goals.
• Ensure the training and onboarding of new staff.
• Provide day-to-day management of staff.
• Perform quarterly performance reviews all Arkos Health STARS/HEDIS staff.
• Provide education regarding STARS/HEDIS initiatives to staff and outside individuals.
• Attend Arkos Health educational and demonstration activities, as needed and directed by Executive Medical Director.
• Perform the duties of STARS/HEDIS team members, as needed.
• Review data collected and develop strategies to improve performance.
• Implement strategies to improve department performance.
• Create, maintain, and improve written department process flows and procedures to improve the functioning of the department.
• Ensure gaps in care are captured.
• Coordinate and order preventative and diagnostic tests around gaps in care on behalf of the primary care physician utilizing standing orders/protocols required by the health plan.
• Conduct data entry and maintain appropriate documentation and tracking for quality initiatives.
• Educate patients on procedures that are being performed and the reason for performing them.
• Participate in member chart review by conducting data extraction/collection using Insurance/Medicare guidelines.
• Collaborate with the PCP in the management and care coordination for members with open gaps of care.
• Demonstrate the ability to work collaboratively, efficiently, and effectively as a high performing quality team member, including collaborating with stakeholders when applicable.
• Coordinate and participate in internal and external meetings.
• Contribute as an active participant in quality initiatives.
• Follow Arkos Health procedures, practices, policies, and guidelines to ensure the safety, security, and well-being of patients.
• Perform other duties as assigned to support the overall effectiveness of the organization.

RN Care Manager – Field-based

• Provide oversight and direction to the STARS/HEDIS department.
• Hold staff accountable to Departmental goals.
• Schedule and follow up on clinical care needs for patients as it relates to Quality Data.
• Manage staff in the STARS/HEDIS Department and assist staff in quality initiatives.
• Collect, report, and respond to metrics.
• Contribute to the organization's drive to improve the overall experience of patient care.
• Review and provide performance feedback to the STARS/HEDIS department.
• Establish annual and monthly departmental and individual staff goals.
• Ensure the training and on-boarding of new staff.
• Perform quarterly performance reviews for all Arkos Health STARS/HEDIS staff.
• Provide education regarding STARS/HEDIS initiatives to staff and outside individuals.
• Attend Arkos Health educational and demonstration activities.
• Review data collected and develop strategies to improve performance.
• Implement strategies to improve department performance.
• Create, maintain, and improve written department process flows and procedures.
• Ensure gaps in care are captured.
• Coordinate and order preventative and diagnostic tests around gaps in care on behalf of the primary care physician.
• Conduct data entry and maintain appropriate documentation and tracking for quality initiatives.
• Educate patients on procedures being performed.
• Collaborate with the PCP in the management and care coordination for members with open gaps of care.
• Demonstrate the ability to work collaboratively as a high performing quality team member.
• Coordinate and participate in internal and external meetings.
• Contribute as an active participant in quality initiatives.
• Follow Arkos Health procedures, practices, policies, and guidelines to ensure the safety, security, and well-being of patients.

• Providing oversight and direction to the STARS/HEDIS department
• Holding staff accountable to Departmental goals
• Scheduling and following up on clinical care needs for patients as it relates to Quality Data, including but not limited to Healthcare Effectiveness Data and Information Set (HEDIS)
• Managing staff in the STARS/HEDIS Department and assisting staff in quality initiatives, including STAR initiatives
• Collecting, reporting, and responding to metrics and contributing to the organization's drive to improve the overall experience of patient care
• Reviewing and providing performance feedback to the STARS/HEDIS department
• Establishing annual and monthly departmental and individual staff goals
• Ensuring the training and on-boarding of new staff
• Performing quarterly performance reviews of all Arkos Health STARS/HEDIS staff
• Providing education regarding STARS/HEDIS initiatives to staff and outside individuals
• Attending Arkos Health educational and demonstration activities, as needed and directed by Executive Medical Director.
• Performing the duties of STARS/HEDIS team members, as needed
• Reviewing data collected and developing strategies to improve performance
• Implementing strategies to improve department performance
• Creating, maintaining, and improving written department process flows and procedures
• Ensuring gaps in care are captured
• Coordinating and ordering preventative and diagnostic tests around gaps in care
• Conducting data entry and maintaining appropriate documentation and tracking for quality initiatives
• Educating patients on procedures that are being performed
• Participating in member chart review by conducting data extraction/collection using Insurance/Medicare guidelines
• Collaborating with the PCP in the management and care coordination for members with open gaps of care
• Demonstrating the ability to work collaboratively as a high performing quality team member

• Work directly as a member of the Arkos Health Interdisciplinary Team
• Implement and participate in the patient’s plan of care; update and revise as needed
• Assist in coordination of comprehensive care; including referrals to internal services (In Home Wellness, Social Services Care Management, Quality Coordination) and external interdisciplinary services to help prevent acute care utilization.
• Maintain case load based on the needs of the client and/or contractual obligation
• Conduct face to face visits at a minimum of every 2 weeks for assigned patients enrolled in Intensive Case Management.
• May conduct increased face to face or telephonic visits based on the needs of the patient and or contractual obligation
• Complete Clinical and Social Assessments (CSA) to develop care plan upon initial start of care visit with patient
• Provide communication with patient’s providers and medical specialists regarding patient status and any changes in condition
• Engage with Arkos Health leadership and contracted providers to resolve changes in patient status, complaints, or complications though participation in weekly ICT meetings
• Complete medical reconciliation for all transitional care patients within 30 days of initiation of TCM contact
• For this field-based position, individuals must be able to travel up to 80% of the time in their own personal vehicle

Medical Director

• Provide supervision and guidance through clinical leadership to the care management teams
• Maintain and ensure the successful process flow of all clinical programs established with our contracted partners
• Provide oversight and ongoing training to care management clinicians
• Establish and evaluate operational/staffing criteria for Clinical Service departments including but not limited to Complex Care Management, and Hospital/SNF Care Management
• Interact proactively with network providers/offices to educate on organization services, problem solve and resolve care management/care coordination related issues or concerns
• Identify and submit to the Chief Clinical Officer any potential quality issues for review
• Prepare and investigate any quality issues or complaints involving the clinical team
• Collaborate with the clinical team for process improvement and assurance of operational quality as well as, HIPAA compliance according to corporate and compliance policies
• Conduct weekly audits of care management team cases, to ensure corporate and partner compliance is met
• Prepare and appropriately delivery weekly Interdisciplinary Care Team agenda and participates in meetings according to contracted standards
• Maintain and audit weekly time and mileage sheets for all applicable staff
• Act as a resource for all clinical staff for any operational or clinical concerns
• Conduct performance evaluations and formulates disciplinary action plans, as appropriate
• Participate and equally shares in after-hour and week-end coverage for Clinical Services Department
• Work with the assigned HR team to conduct recruitment, hiring, and training of required personnel

Director of Clinical Services

• Work directly as a member of the Arkos Health Interdisciplinary Team
• Implement and participate in the patient’s plan of care; update and revise as needed
• Assist in coordination of comprehensive care; including obtaining referrals to other interdisciplinary services ( In Home Wellness, Care Coordination, Population Health, Care Management to help prevent further need for acute care utilization
• Maintain case load based on the needs of the client and/or contractual obligation
• Conduct face to face visits at a minimum of every 2 weeks for assigned patients enrolled in Intensive Case Management. May conduct increased face to face or telephonic visits based on the needs of the patient and or contractual obligation
• Complete Clinical and Social Assessments (CSA) to develop care plan upon initial start of care visit with patient
• Provide communication with patient’s providers and medical specialists regarding patient status and any changes in condition
• Engage with Arkos Health leadership and contracted providers to resolve changes in patient status, complaints, or complications though participation in weekly ICT meetings
• Complete medical reconciliation for all transitional care patients within 30 days of initiation of TCM contact
• For this field-based position, individuals must be able to travel up to 80% of the time in their own personal vehicle

RN Care Manager – Central Montana

• Provide support and social services to health plan members and their families in accordance with an appropriate plan of care
• Schedule and complete face to face visits with patients/families/caregivers and perform in-home and telephonic assessments of needs
• Complete assessment for social service needs to address barriers to health care and develop, monitor, and evaluate care plans
• Assist and provide resources, information, and referrals to support the care plans
• Participate in interdisciplinary team (ICT) meetings to establish, review, and revise the patient care plan
• Maintain electronic medical records
• Support patient, family, and caregivers with cultural and spiritual sensitivity and provide holistic, family-centered care across treatment settings to improve quality of life
• Provide supervision and guidance to the member support specialist team
• Travel to patients' homes in the valley up to 80% of the time and assist members in home, community, or clinic settings

Social Services Case Manager

• Schedule and complete face to face visits with patients/families/caregivers
• Complete assessment for social service needs to address barriers to health care
• Assist and provide resources, information, and referrals to support the care plans
• Participate in interdisciplinary team (ICT) meeting to establish, review, and revise the patient care plan
• Maintain electronic medical records
• Support patient, family, and caregivers with cultural and spiritual sensitivity
• Provide holistic, family-centered care across treatment settings to improve the quality of life
• Provide supervision and guidance to the member support specialist team
• This person will travel to patients' home in the valley up to 80% of the time
• *This position requires you to assist members in their homes, community, or clinic setting.

• Work directly as a member of the Arkos Health Interdisciplinary Team
• Implement and participate in the patient’s plan of care; update and revise as needed
• Assist in coordination of comprehensive care; including obtaining referrals to other interdisciplinary services (Home Health, Palliative Care, Social Services) to help prevent further need for acute care utilization
• Maintain case load based on the needs of the client and/or contractual obligation
• Conduct face to face visits at a minimum of every 2 weeks for assigned patients enrolled in Intensive Case Management; may conduct increased face to face or telephonic visits based on the needs of the patient and or contractual obligation
• Complete Clinical and Social Assessments (CSA) to develop care plan upon initial start of care visit with patient
• Provide communication with patient’s providers and medical specialists regarding patient status and any changes in condition
• Engage with Arkos Health leadership and contracted providers to resolve changes in patient status, complaints, or complications though participation in weekly ICT meetings
• Complete medical reconciliation for all transitional care patients within 30 days of initiation of TCM contact
• Responsible for working with patients and their families to ensure a smooth transition following discharge from any facility
• Provide transitional and intensive nurse care management services for the network and collaborate with health plan leadership and department coordinators

Arkos Health

RN Care Manager – Field-Based

RN Care Manager

RN Case Manager

Quality Manager – STARS, HEDIS

Quality Manager – STARS, HEDIS

Quality Manager – STARS, HEDIS

RN Care Manager – Field-based

Quality Manager – STARS, HEDIS

Quality Manager – STARS, HEDIS

RN Care Manager

RN Care Manager

Director of Clinical Services

RN Care Manager – Central Montana

Social Services Case Manager

Social Services Case Manager

RN Care Manager, In-Home Assessment

RN Care Manager - In-Home Assessment