Provides care under the direct supervision of the Population Health Director of Care Management or Nurse Manager utilizing physician approved patient protocols according to established standards and best practice guidelines. Facilitates the communication between patient/caregiver, physician and the outpatient care team to optimize health and wellness, reduce inpatient admission, reduce re-admissions and improve medical stability in the patient population served. Works collaboratively with Nurse Navigators to manage medical stability in patients with high risk disease management with complex comorbid conditions.
Manages a case load of 10,000-15,000 patients with identified gaps in care in collaboration with the Health Care Team.
Works in collaboration with the PCMH Team in the design, implementation and evaluation of the PMH model as applicable.
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.