Thursday, March 31, 2011

Job Posting for a Care Manager


Manager of Care Management

Seattle, WA

The Manager of Care Management is a full time position, responsible for assisting the Director of Medical Care Management in the day to day management of operational, clinical and functional support for the following programs:

Enhanced Concurrent Review - Medical Utilization Management, The Manager supervises staff in multiple locations including remote or telecommuter staff.. Responsibility for hiring, coaching and completion of performance evaluations. Assists with policy and procedures, accreditation and regulatory standards. Offers input and works with the appropriate departments to support
the development and launch of new and existing programs, reporting and/or technology; Works with our internal and external clients to deliver quality products and provide excellent customer service.


Licensed RN with current, unrestricted license required
Bachelor's degree preferred in a health science


Two-three years clinical experience in care management or acute hospital discharge planning required.
Three years full-time direct clinical or critical care to patients in a medical/surgical setting.
5 years experience in Triage or Utilization Management or Case Management, and/or other managed care or cost management program.
At least 5 years Call Center Management experience preferred.
Experience with application of healthcare criteria systems and programs, e.g. Triage, InterQual, Milliman, CMS.
Must have previous experience with URAC and or NCQA accreditation process.


Ability to manage and coordinate programs, projects, resources, and staff across multiple company functions;
Strong administrative qualities to analyze goals, products, programs, and processes and make recommendations for changes;
Knowledge of all aspects of the following managed care products: utilization management, case management, disease management and triage;
Organizational and project management skills;
Experience working with clinical documentation programs designed for case management, disease management, utilization management and triage programs;
Strong computer skills and experience with Microsoft Office;
Strong communication, interpersonal and leadership skills.

Job Performance/Responsibilities

Coordinates and manages all Medical Utilization Management, Case Management, and Nurse Triage programs.
Assure job descriptions and staff roles/responsibilities are accurate and current
Responsible for supervision and oversight of staff
Supervise the interviewing and hiring of staff and supervisors for the above programs;
Assist in the licensing and accreditation process for all programs;
Assure that all regulatory and accreditation standards are implemented and met;
Assure that Policies & Procedures, Operational Guidelines, and process workflows are current meet quality accreditation and regulatory standards, and are communicated to and available for staff on the IntraNet;
Develop annual Workplan & Evaluation for each program in conjunction with the QI committee (includes goals, objectives, and planned new processes/enhancements) and communicates the Annual Workplan and previous year's Summary to Senior Management and staff;
Assist the Quality department in the development and evaluation of an annual QI plan for all programs and assures all indicators are met;
Participate in the Quality Committee and assists in related functions;
Analyze all programs to ensure effectiveness, quality, productivity, profitability and patient safety;
Coordinate all programs and work with other Health Integrated Departments and Committees, i.e. Quality Committee, Education, Account Management, etc;
Assist in new product development efforts and assures current products are being delivered as designed;
Assist the Director in plans for growth;
Provide input and direction to Information Services on systems issues and enhancements;
Offer input and assist with development of orientation, education and training programs
Assure delivery expectations of client contracts are being met;
Assist in the development of management reporting capabilities and works with supervisors to ensure they understand and use them to effectively manage the delivery of services; and provide required reports and special projects as needed.
Ensure clinical staff consult and seek advice from a licensed physician with expertise appropriate to the types of services being managed

Please direct all inquiries to David Mara at (804) 402-8088 or e-mail at For more information about Nexus Healthcare go to

Wednesday, March 30, 2011

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Saturday, March 26, 2011

Hypnosis: Does it Really Work?

Hypnosis has become a popular treatment in a variety of areas, and many people seeking self-improvement have had positive reports on its effectiveness. The origins of this therapy date back to ancient times, with roots in spiritual meditation and mass chance or prayers. In modern practice, hypnosis has been used as a means for patients to positively change patterns of behavior that have negative impacts on their everyday lives. These behaviors often include smoking, poor diet, phobias, exam anxiety, and various mood disorders. Hypnosis also has its applications in medical treatments for some physical conditions such as allergies, headaches, and fibromyalgia. Studies have shown that when hypnosis is combined with traditional medicine and /or therapies, the results are often better than with conventional treatment alone.

According to John H. Stewart of the Mayo Clinic, smokers with goals of quitting have had much higher success rates when they have sought the help of a hypnotherapist. In controlled studies, smokers who have undergone hypnosis were up to three and half times more likely to completely give up cigarettes over the courses of their lifetimes. Similar results have been shown for patients who are seeking to lose weight through healthier eating habits. Medical professionals who have studied hypnosis and hypnotherapy believe that these types of successes come from the increased susceptibility to suggestion that occurs in the mind during hypnosis sessions.

Hypnosis has also been effective in reducing anxiety during high-stress situations such as surgery or important exams. A study performed at London's Imperial College of Medicine has shown that medical school students who underwent a certain number of hypnosis treatments were less susceptible to illness and were more relaxed while taking tests. The same has been reported for patients undergoing surgery. When hypnosis has been used prior to general anesthesia, many patients have had easier times managing their healing processes after surgery.

While some doctors and therapists may apply hypnosis more than others, plenty of evidence does support its helpfulness as part of a path to improved health. Hypnosis results present a strong case about the close connections between mind and body, and it is likely to have further advancements along with the rest of modern medicine.

Many health care professionals today are training to become certified hypnosis and hypnotherapy practitioners. While there are many programs available today, people must be cautious against programs that provide too little education and training. Training programs should generally provide for approximately two hundred hours of hypnosis courses and a clinical practicum. Less training than this will not prepare professionals to practice at a high level of proficiency. When seeking out a hypnosis or hypnotherapy practitioner, also check to see if the practitioner holds a national certification from a recognized certifying agency. This is important as certification provides consumers with the assurance that the practitioner is appropriately educated and adheres to high ethical and practice standards. The American College of Hypnotherapy is one organization that has developed high quality education standards and provides for continuing education for its members.


Gruzelier, J., Levy, J., Williams, J., & Henderson, D. (2001). SELF-HYPNOSIS AND EXAM STRESS: COMPARING IMMUNE AND RELAXATION-RELATED IMAGERY FOR INFLUENCES ON IMMUNITY, HEALTH AND MOOD. Contemporary Hypnosis, 18(2), 73. Retrieved from EBSCOhost.

Halsband, U., Mueller, S., Hinterberger, T., & Strickner, S. (2009). Plasticity changes in the brain in hypnosis and meditation. Contemporary Hypnosis, 26(4), 194-215. doi:10.1002/ch.386

Stewart, J. H. (2005). Hypnosis in Contemporary Medicine. Mayo Clinic Proceedings, 80(4), 511-524. Retrieved from EBSCOhost.

Friday, March 25, 2011

Lower Back Pain: Innovative 3D Models Help In Pre-Surgical Planning

by Jeffrey Arnold

People who suffer from Back soreness know how difficult it can be to discover the exact problems within their backs. Even more difficult is finding the right treatment.

Often chiropractic therapies are effective because their holistic approach in actually handling the spine of a conscious patient. An experienced chiropractor has a sort of sixth sense aided by an enhanced sense of touch and an awareness of pain. Sometimes physical therapists have a similar understanding. However even they cannot know for certain what lies on the inner side of a human spine. Though they palpate, and interpret tension in parts of the back to gain an understanding of the spine, they aren't all knowing.

Unfortunately when chiropractic therapies fail because of bone or disk deterioration, or other severe damage, one is forced to go to an orthopaedic surgeon. Back surgery should always a last resort as treatment for a back ache. Unfortunately with lower back pain it is sometimes the only answer. Only after one has tried every other resource, worn back braces and seen many physical therapists and received spinal decompression therapy from a few different physicians should they consider surgery.

A innovative new diagnostic tool enables surgeons to prepare better for a specific surgery. ACRM Corp has brought a whole new dimension to Back pain diagnostics and pre surgery evaluation. The new process creates a three dimensional model of a specific patient's spine, based on CT and MRI scans. This enables the surgeon to completely examine and even practice on a working replica of the patient's entire back in a way previously impossible. The procedure is brand new and so many orthopedic surgeons still aren't using it. Eventually it is expected to become the industry standard. Eventually 3-D models of each spine will probably be made mandatory before surgery.

The cost of a typical 3D model is only a thousand dollars, or about half the price of an MRI scan. Back surgeries often cost over $110,000 dollars. Thus having a 3-D model created is relatively cost effective as an additional diagnostic tool which will improve the outcome of a costly and potentially dangerous procedure. Patients should request, or at least suggest 3-D models to their orthopedic surgeons who may not be aware of this innovative tool. 3-D models might also be helpful to other non surgical situations as well.

ACRM Corp is pioneering the development and sales of patient specific, Anatomically Correct, three-dimensional Reference Models, from CT and MRI scans to assist with skull or back surgeries. Visit their website ( for more information about how these three-dimensional models can help your orthopedic physician in their pre-surgical planning.

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