The RN Care Manager position requires a thorough understanding of clinical, financial, administrative, and psychosocial components of care management. The RN Care Manager is responsible for providing assessments, planning, interventions and follow-up for patients and family members at SHC across the continuum of care. These services are prov ided face to face or telephonically; to facilitate the creation and adherence to a treatment plan and optimize patient health. In conjunction with the interdisciplinary team; this position proactively addresses potential or actual needs identified through screening to ensure developmental, level of care and health status transitions are safe, seamless, and coordinated.
Some responsibilities include but are not limited to:
Patient advocacy while adhering to plan of care
Works collaboratively with interdisciplinary team
Performs intake assessments for new patients
Provides discharge/transition assessments
Identifies barriers to successful clinical outcomes
Facilitates medication management
Hands off communication; works with medical home, documents assessments, interventions, plans, and education in the EMR
Participates in system-wide development of clinical best practice pathways
Provides patient education materials, order sets, and implements successfully.
Current unrestricted PA RN license 3 yrs. experience in Case Management, BSN or 5 years clinical experience. InterQual, Disease Management, applying regulatory requirements, working knowledge of community resources, working with uninsured/underinsured populations preferred. CCM, required