Job Description / Performance Appraisal

Name: ______

Great Falls Clinic, LLP

JOB DESCRIPTION / PERFORMANCE APPRAISAL

Job Title: RN Health Coach Human Resources:______

Name: Reviewer:

Employee ID # (last 4 of SSN): ______Review Date: ______

Department: ______Next Review Due: ______

Addendum: Yes

No

FLSA Exempt: Yes

X No

Organizational Relationships:

·  Receives direction from:

·  Gives direction to:

·  Works cooperatively with:

Position Overview:

The key job duties of the RN Health Coach are to assess, plan, implement, monitor, and evaluate options and services to effect an appropriate, individualized plan for the patient across the continuum of care. These duties focus on:

·  Chart pre-screening to identify gaps in care;

·  Short-term follow-up with patients on plan of care changes; and

·  Behavorial modification.

Using independent judgment and discretion, the continuum of care must be reassessed as an ongoing process for the individual being served by the Health Coach. The process addresses the individual’s broad spectrum of needs. The Health Coach utilizes clinical knowledge and competence, positive communication skills, problem solving and conflict resolution techniques, ability to effect change, strong skills in assessment, organization, and time management. This process requires a focus on customer service skills, knowledge of setting appropriate goals and measuring outcomes to effectively ensure optimal client outcomes with consideration to payer requirements.

Minimum Education and/or Experience Required:

·  Education: Registered Nurse with current MT State Licensure

·  Knowledge:

·  Knowledge of acute care, home care, subacute care, long-term care, hospice interventions, and rehabilitation options and requirements.

·  Maintains knowledge of requirement to Third Party Administrators, regulatory agencies, and managed care entitites concerning levels of care, continuity of benefits, and medical necessity guidelines.

·  Maintains knowledge of the quality assurance process and determination of positive outcomes.

·  Uses clinical experience, knowledge of managed care and the current standards and trends in health care, best practices, management tools, and familiarity with related resources and literature.

·  Skills:

·  Basic knowledge of personal computer and software for word processing and/or good keyboard skills preferred, or the ability to enter and retrieve data from relevant computer systems.

·  Ability to effectively communicate with all levels of patients, TPA, physicians, health care personnel, supervisory staff, and peers.

·  Demonstrates the ability to be organized and efficient in prioritizing and managing assignments with minimal oversight and direction.

·  Demonstrates the willingness to research, learn, and to obtain knowledge for the performance of the position.

·  Demonstrates a courteous, professional demeanor and team spirit and the ability to work in a collaborative, effective manner.

·  Ability to utilize critical thinking and apply sound clinical judgment and assessment skills for decision-making.

Additional Experience and/or Qualifications:

·  Experience in case management and quality improvement preferred.

Licensure/Certification Required:

·  Achievement of Certified Case Manager (CCM) is strongly encouraged.

An equivalent combination of education and experience sufficient to successfully perform the essential duties of the job such as those listed in this job description will also be acceptable when applicable.

List any specialty-specific certifications or licensures on an addendum and attach to job description.

Complete the Job Requirements-Physical/Environmental Factors form and attach it to any new job description.

Definitions:

RATING: DESCRIPTION:

Consistently Meets Standard (MS) Performance and demonstrated behaviors consistently meet the performance standard. Performance is what is expected of a fully qualified individual. Outcomes meet expectations.

Needs Improvement (NI) Performance and demonstrated behaviors do not meet minimum standards. Excessive guidance and instruction is required to reach expected outcome. This standard needs immediate attention and improvement.

Unable to Assess (UA) There has not been enough observation to develop a rating or the standard has not been a job assignment during the review period.

OUR POLICY

Our performance appraisal program is designed to provide a basis for better understanding between you and your supervisor with respect to your job performance, as well as your apparent potential and personal development within the Clinic.

THIS DOCUMENT

This document is intended to summarize your job and its essential functions and to summarize discussions regarding job performance standards / objectives and personal goals that have been ongoing throughout the year. It is also to be used as a tool to help focus discussions and plan development for future objectives. Supervisors and employees are expected to review progress towards meeting planned goals and objectives throughout the year, as part of their normal and routine working relationship.

I. SPECIFIC JOB RESPONSIBILITY PERFORMANCE FACTORS (These are the essential duties of the job as outlined in the job description)

1. / Health Coach Care Management: Manages care of patients with chronic disease through the health care system based on the individual’s needs. Appropriately ingetrates the individual in the health care continuum including procuring of services, health promotion and counseling, disease prevention, health education and screening, and community resources linkage.
Performance Levels
Performance Expectations / Accountabilities / UA / NI / MS
a) Uses independent judgement and discretion, identifies and plans strategies to reduce in-patient length of stay and resource consumption. Works in collaboration with physicians and appropriate health care providers for changes in plans as required. Provides patient/family or significant other with information about nursing visits, home care, and appropriate providers.
b) Advocates for the patient and family throughout the entire episode of care. Maintains availability to the patient/family as a resource to facilitate communication among providers and to monitor services rendered. Remains involved until the patient achieves the planned level of functional health or closure criteria are met.
c) Coordinates/facilitates the patient’s progression throughout the continuum.
d) Works collaboratively and maintains active communication with physicians, nurses, social workers, utilization review staff, and other members of the multidisciplinary care team to effect timely, appropriate patient management through the continuum.
e) As appropriate, meets directly with the patient/family and multidisciplinary team based on identified needs.
f) Applies knowledge of age-specific, cultural diversity, psycho/social, and developmental issues during the interview process, documentation and intervention with the patient, their family, or significant others.
g) Remains in communication with patients and the physicians and other members of the health care team to identify and resolve variances concurrently, and to assist the patient in attaining the appropriate care with positive outcomes.
h) Knowledgeable of new regulations on the federal, state, and local level.

Comments:

2. / Process and Relationships:
Performance Levels
Performance Expectations / Accountabilities / UA / NI / MS
a) Collaborates with the physician and the multidisciplinary team to facilitate the plan of care and assist in identification and concurrent resolution of variances.
b) Uses independent judgment and discretion to address, resolve, and process problems impeding the diagnostic or treatment progress. Proactively identifies and resolves delays and obstacles.
c) Seeks consultation from physicians, clinical, and other disciplines and departments as required to facilitate.
d) Collaborates and communicates with all members of the multidisciplinary team to validate information.
e) Identifies potential risk factors.

Comments:

3. / Service Delivery: Manages aspects of the planning process in anticipation of patient variances or transitions.
Performance Levels
Performance Expectations / Accountabilities / UA / NI / MS
a) Collaborates and communicates with the physician and the rest of the multidisciplinary team to facilitate planning for variances or transitions.
b) When appropriate, meets directly with the patient/family based on identified needs. Develops an individualized comprehensive plan of care in collaboration with the physicians and multidisciplinary team.
c) Initiates and facilitates referrals for home health care, infusion therapy, hospice, other care facilities, and medical equipment and supplies.
d) Facilitates transfers to other facilities.
e) Identifies “at risk” individuals and develops and implements a comprehensive plan of care that addresses the specific need.
f) Completes reports on time.
g) Remains current on Health Coach documentation.

Comments:

4. / Quality and Performance Improvement:
Performance Levels
Performance Expectations / Accountabilities / UA / NI / MS
a) Appropriately identifies potential issues or “at risk” populations and anticipates the need to provide care.
b) Actively participates in clinical performance improvement process.
c) With respect to the individual patient, analyzes and evaluates the effects of case management on quality outcomes, fiscal parameters, customer satisfaction, and systems operations; and develops strategies to improve performance.
d) Utilizes problem-solving techniques and conflict resolution skills, develops the plan to provide consistent quality to the patient and the payer.

Comments:

5. / Managed Care and Regulatory Knowledge: Collaborates with the multidisciplinary team to assist patient with benefits/resource management.
Performance Levels
Performance Expectations / Accountabilities / UA / NI / MS
a) Communicates, as required, with patients to provide understanding of plan language and/or payer guidelines.

Comments:

6. / Communication: Maintains open communication with all appropriate parties.
Performance Levels
Performance Expectations / Accountabilities / UA / NI / MS
a) Utilizes problem-solving skills and negotiating techniques to resolve conflict issues.
b) Identifies, plans, and corrdinates aspects of care for the patient, their family, or significant other.
c) Communicates with supervisory personnel for problem solving, direction, an dplanning as well as knowledge issues.
d) Initiates required forms and/or letters to comply with organizational guidelines.
e) Interacts with the physicians and members of the entire health care team in appropriate time frames.
f) Maintains strict standards for patient confidentiality and patient-related information in addition to security of electronic information; complies with organizational, federal, and state regulations and policy on confidentiality.

Comments:

7. / Professional Development:
Performance Levels
Performance Expectations / Accountabilities / UA / NI / MS
a) Maintains current knowledge of plan language and benefit issues and requirements as it relates to potential denial (whether contractual or utilization related).
b) Attends educational training program to expand job knowledge.
c) Performs other duties as related to Health Coach functions to support and foster an effective, quality Health Coach program.

Comments:

II. GENERAL PERFORMANCE FACTORS

1. / Knowledge: / UA / NI / MS
Demonstrates technical competence in field and the ability to apply that knowledge and stay abreast of new developments; attends and participates in classes, seminars, workshops and other continuing education as appropriate to maintain and enhance knowledge and/or job skills.

Comments:

2. / Problem Solving and Creativity / UA / NI / MS
Ability to define problems and develop workable solutions and integrate into processes.

Comments:

3. / Planning & Organization: / UA / NI / MS
Ability to plan long and short-range objectives/ priorities and develop effective work schedules.

Comments:

4. / Flexibility & Adaptability: / UA / NI / MS
Ability to respond to changing organizational, project or job requirements and to meet changing technical/service/business needs.

Comments:

5. / Ability to Work Independently: / UA / NI / MS
Displays the appropriate amount of initiative and independence for the job and make positive contributions; is a self-starter

Comments:

6. / Ability to Work with Others: / UA / NI / MS
Willingness to coordinate with others to meet overall project or service objectives; fosters teamwork, personal responsibility, integrity, innovation, trust and communication; recognizes the positive contribution of others and offers encouragement and constructive feedback; helps develop team cohesiveness, and aligns individual efforts with the group; freely shares knowledge and information with co-workers.

Comments:

7. / Meets Schedules: / UA / NI / MS
Ability to meet schedules; completes assignments on time, contributing extra effort needed when circumstances hinder progress; assists overloaded team members; reports to work on time; and takes breaks appropriately.

Comments:

8. / Supports Organization and Vision: / UA / NI / MS
Encourages others to take pride in the organization, its vision and its people; supports Clinic’s policies and procedures and conducts work in an ethical manner.

Comments:

9. / Verbal & Written Communication: / UA / NI / MS
Ability to effectively communicate through verbal interactions, reports, and memos, etc. can organize and run effective meetings.

Comments:

10. / Overall leadership skills: / UA / NI / MS
Behaviors demonstrate ability to effectively plan, develop and implement overall organizational objectives.

Comments:

11. / Customer Focus / UA / NI / MS
Dedication to exceeding expectations of customers (internal and external customers); contributes ideas/suggestions and participates in activities for improving processes and services to our customers; participates in evaluating and monitoring feedback from customers for improving efficiency and services; listens carefully to ensure understanding.

Comments:

12. / Respect for Others / UA / NI / MS
Fosters respect and demonstrates mutual respect of individual differences such as culture, race, religion, age, disability, socioeconomic status, education, sexual orientation, veteran status, marital status, or gender; treats others with dignity and contributes to a work place free from harassment.

Comments:

13. / Broad, Encompassing Perspective / UA / NI / MS
Looks toward the broadest possible view and sees relationships and patterns.

Comments:

14. / Learning Ability / UA / NI / MS
Willing and able to learn from situations and people; accepts feedback and applies it to the improvement of individual performance.

Comments:

15 / Develops People (for supervisors) / UA / NI / MS
Recognizes the individual ability and career goals of employees and creates growth opportunities.

Comments:

16 / Confidentiality / UA / NI / MS
Protects the confidentiality of all sensitive oral, paper-based and electronic information and restricts the flow of such information to those who have a legitimate “need to know.” Conducts discussions of confidential information in appropriate settings to avoid unintentional disclosure.

Comments:

17 / Behavior Management / UA / NI / MS
Effectively manages anger, emotions, and frustration; contributes to a good work environment.

Comments:

18 / Reliability / UA / NI / MS
Complies with the Clinic’s absence policy (excludes absences related to Family Medical Leave).

Comments:

19 / Safety / UA / NI / MS
Performs activities in a manner that ensures a safe environment for customers and employees.

Comments:

III. TRAINING AND DEVELOPMENT

1.  Please list courses, workshops, seminars and on-the-job training completed since the last review: