Registered Nurse (RN) - Case Manager - Homecare at Abarca Health

Sioux Falls, South Dakota, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Registered Nurse (RN) license from Board of Nursing upon hire
Visual acuity adequate to perform position duties
Ability to communicate effectively with others, hear, understand, and distinguish speech and other sounds
Preferred: 1-3 years in home health or hospice
Commitment to Avera’s mission, vision, core values, and social principles
Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE)

Responsibilities

Develop all patient care plans in collaboration with the physician and interdisciplinary team, providing patient-centered care efficiently, effectively, with the best possible outcomes
Function as an interventionalist in the home utilizing clinical expertise and problem-solving to make recommendations to physicians based on comprehensive physical, psychosocial, emotional, spiritual, and bereavement patient assessments
Implement the nursing process utilizing highly proficient assessment skills in Start of Care visits, post-hospital evaluations, patient re-certifications, discharges, and supervisory visits
Partner with the physician and interdisciplinary team to develop the plan of care in collaboration with the patient
Make recommendations for efficient and effective utilization of resources to achieve positive outcomes by implementing clinical protocols during the admission visit as dictated by patient’s diagnosis
Initiate and respond to requests for changes in plans of care, determine appropriateness of change, and assess if it constitutes a Significant Change in Condition requiring an OASIS
Demonstrate ability to affect the behavior of others to follow recommended alternatives to care, including providing thorough instruction and disease management education to patients and/or caregivers as ordered by the physician
Educate patients, families, and caregivers about disease process, community resources, and recommended self-care
Responsible for care planning, utilization of services, coordination of care, and education of interdisciplinary teams in the management of patient care services

Skills

Case Management

Home Health Nursing

Nursing Assessment

Care Planning

Nursing Process

Interdisciplinary Collaboration

Patient Assessment

Discharge Planning

Utilization Management

Recertification

Abarca Health

Pharmacy Benefit Management services provider

About Abarca Health

Abarca Health provides Pharmacy Benefit Management (PBM) services, focusing on flexible and user-friendly solutions for health plans, employers, and government programs like Medicare and Medicaid. Its main product, the Darwin platform, allows clients to quickly implement and modify benefit designs while ensuring compliance with regulations. Abarca Health manages over $5.3 billion in drug spend and processes 100 million prescription claims annually, offering additional services like home delivery for prescriptions. The company's goal is to deliver exceptional service and innovative solutions in the PBM market.

Aventura, FloridaHeadquarters

2005Year Founded

VENTURE_UNKNOWNCompany Stage

HealthcareIndustries

501-1,000Employees

Benefits

PTO

Parental leave

Work flexibility

Health insurance

Wellness stipend

401k

Tuition reimbursement

Leadership development programs

Risks

Increased competition from Amazon Pharmacy and Mark Cuban's Cost Plus Drug Company.

Growing focus on specialty drugs may require platform adaptation.

Shift towards price transparency could pressure Abarca's pricing models.

Differentiation

Abarca Health's Darwin platform is highly adaptable and user-friendly.

The company offers innovative programs like Triple S en Casa for home delivery.

Abarca Health ensures compliance with ever-changing healthcare regulations.

Upsides

Abarca transitioned two million members to Darwin in 18 months, showing operational efficiency.

Collaboration with Blue Shield of California boosts Abarca's reputation in the PBM sector.

Recognition as a top IT workplace attracts top talent, driving innovation.

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