Assistant Manager - QA Assessment & Care Manager RN

About
Capgemini

With
more than 180,000 people in over 40 countries, Capgemini is a global leader in
consulting, technology and outsourcing services. The Group reported 2015 global
revenues of EUR 11.9 billion. Together with its clients, Capgemini creates and
delivers business, technology and digital solutions that fit their needs,
enabling them to achieve innovation and competitiveness. A deeply multicultural
organization, Capgemini has developed its own way of working, the Collaborative
Business Experience™, and draws on Rightshore®, its worldwide delivery model.

Learn
more about us at www.capgemini.com.

Rightshore®
is a trademark belonging to Capgemini.

Capgemini
is an Equal Opportunity Employer encouraging diversity in the workplace. All
qualified applicants will receive consideration for employment without regard
to race, national origin, gender identity/expression, age, religion,
disability, sexual orientation, genetics, veteran status, marital status or any
other characteristic protected by law.

This
is a general description of the Duties, Responsibilities and Qualifications
required for this position. Physical, mental, sensory or environmental demands
may be referenced in an attempt to communicate the manner in which this
position traditionally is performed. Whenever necessary to provide individuals
with disabilities an equal employment opportunity, Capgemini will consider
reasonable accommodations that might involve varying job requirements and/or
changing the way this job is performed, provided that such accommodations do
not pose an undue hardship.

Click
the following link for more information on your rights as an
Applicant:http://www.capgemini.com/resources/equal-employment-opportunity-is-the-law

Location: Pensacola, FL

Role:

QA Assessment & Care Manager RN

Grade:

Role
Description

Role
Overview:
Through
a quality review process, the QA assessment RN will provide quality
assessments to both internal and external CHCS Service Inc customers. The QA
Assessment RN is responsible for delivery of prompt and courteous service in
a professional level and is responsible for ensuring the quality and
consistency of Telephonic Health Interviews (Phi's), Face-to-Face Interviews
and On-site Assessments as well as clinical supervision of Care Manager’s
documentation on the client’s medical record..
General
Responsibilities / Accountabilities:
Includes
the following. Other duties may be assigned.
1.Makes
outbound calls to field nurse assessors, answers inbound calls from nurses
when needed.
2.Responsible
for all follow up on assessments that are not complete have inconsistent
information or quality issues. Record and maintain detailed notes to identify
the status of each open assessment.
3.Identify
all and any opportunities to enhance production, quality and performance.
4.Maintain
all records with accuracy and quality.
5.Responds
to any internal and external customer inquiries in a timely and professional
manner.
6.Reviews
and QA’s a random selection of 25 RN assessments monthly
7.Conducts
Telephonic Health Interviews as assigned.
8.Reviews
and QA’s Face-to-Face Interviews and On-site Assessments as assigned.
9.Provides
additional training to field nurse assessors by phone as indicated
10.Monitors and
identifies quality issues of documentation on the Comprehensive Assessment
Summary (CAS) and Status Summary, completed by the Care Managers.
11.Performs any
other additional duties as assigned.
Qualifications
(Education/Experience/Certification)
CERTIFICATES,
LICENSES, REGISTRATIONS

Registered Nurse
EDUCATION
and/or EXPERIENCE
Required
Licensed to practice as a Register Nurse in the
state of residence with five or more year’s clinical experience.
Preferred
BSN degree and/or CCM certification a plus.
COMPETENCIES
Clear verbal communication
and written skillsExcellent customer service
skills.Experience within the
Insurance or Medical Industry preferred but not required.Basic knowledge of
Windows, Excel and Word. Adept at using multiple computer applications-working
paperless.

Competencies

Proficiency
Level

Core
Behaviors

Living
Capgemini Values, Diversity, Life Balancing, Professional Integrity, Client
Value & Service Excellence, Collaboration, Flexibility, Initiative,
Resilience, Continuous Learning & Self Development

Meets Expectations

Professional
Competencies

Foundation
Skills:Time/Task
Management, Attention to detail, Conflict Management, Decision Making &
Judgment, Communicating, Presentation, Influencing

3- Proficient

Service
& Delivery:Planning
& Organizing, Managing & Controlling, Requirements Assessment,
Analytical Problem Solving, Solution Design, Project Closure, Documentation

3- Proficient

People
Leadership:Staff
Acquisition, Leadership Conduct, Managing Others, Developing Others

3- Proficient

Client
Acquisition & Development:Managing Relationships, Executive
Interaction, Client Organizational Awareness, Generating & Transforming
Opportunities

N/A

Innovation
& Capability Growth:Awareness of External Environment, Innovation, Capgemini
Business Acumen, Knowledge Sharing / Leveraging Knowledge, Reuse,
Facilitation

3- Proficient

Business
Leadership:Business
Planning & Execution, Global Perspective,Visionary leadership

4- Progressing

Technology
Awareness and Leveraging:Technology Awareness, Technology Leverage

3- Proficient

Role Specific Competencies

BPO
Technology

3- Proficient

Commercial
Control

N/A

BPO
Process

3- Proficient

Analytics

3- Proficient

Proficiency levels

1 -
Master (role model)
·Demonstrated
consistent excellence in applying
this competency
·Recognized
thought leader on this competency
2 -
Experienced (extensive practical application
and experience)
·Demonstrated
consistent achievement in applying
this competency
·Is
routinely sought out to coach others in the application of this competency
3 -
Proficient (practical application and experience)
·Have
applied this competency independently in
many situations
·Capable
of coaching others in the application of
this competency

4 -
Progressing (limited practical application
and experience)
·Applied
this competency but still require guidance to perform successfully
5 -
Baseline (theoretical knowledge)
·Newly
developing this competency and have completed formal training or on-the-job
training
·Have
limited or no applied experience in this competency and require a high level
of guidance to perform successfully
N/A -
Not Applicable
·The
competency is not applicable to the grade/role