PT Disease Management Nurse -RN

We’re Personify Health. We’re the first and only personalized health platform company to bring health, wellbeing, and navigation solutions together. Helping businesses optimize investments in their members while empowering people to meaningfully engage with their health. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.

As a Disease Management Nurse, you will telephonically coordinate wellness and disease management, with a primary focus on conditions such as diabetes, asthma, COPD, CAD, CHF, atrial fibrillation, hypertension, and hyperlipidemia but not limited to this list.

Contact targeted member for health promotion and restoration by the use of national care guidelines to compare patient’s current level of care with industry standards. Use claims processing tools to review and research paid claim data to develop a clinical picture of a member’s health; create an individual care plan for each patient; provide close follow-up with patients actively managed. Work with patients to ensure they have a primary care provider; assist in referrals to specialists if needed; assist in obtaining durable medical equipment, review pricing for high-cost drugs. Evaluate and make referrals for case management, prenatal program or pharmacology review as indicated. Document interventions and patient contact; maintain privacy of member’s records and assist in providing quarterly reports to clients. Track groups of high-risk members and interventions to show overall health improvement within the organization. Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis.