RN Care Manager

Position Summary

The RN Care Manager addresses the needs of the Managed Medicaid Population at Advance Community Health by assessing, planning, implementing, coordinating, monitoring and evaluating the options and services required by using communication and available resources to promote quality, cost-effective outcomes. Working within the Registered Nurse scope of practice and in collaboration with the Primary Care Provider, patient, caregivers, family members, other members of the Care Management Team as well as the community, to coordinate a full continuum of health care services considering the holistic needs of the patient, inclusive of unique social and cultural dynamics.

Essential Duties and Responsibilities

• Provide effective Care Management Services based on case management standards of practice to enrolled patients.
• Complete comprehensive assessments considering the total individual, inclusive of medical, biopsychosocial, behavioral, spiritual and cultural needs to enrolled patients throughout the continuum of care.
• Develop, review and evaluate the member care plan in partnership with the member, caregiver/family members, providers and Care Management team members.
• Identify and address barriers that impede health outcomes.
• Provide education to patient/family about clinical diagnosis, medications, available resources, prevention and risk factors to achieve optimal self-management.
• Implement Care Management interventions per the patients care plan.
• Work collaboratively with multi-disciplinary team members to facilitate achievement of desired treatment.
• Abide by organizational guidelines, policies and HIPAA regulations.
• Attend departmental meetings, trainings and other events as required.

Other Duties Assigned

• Perform other duties as assigned or become necessary by supervisor.

Education and Experience

• Licensed RN (associate or bachelor’s degree) 
• Minimum of 5 years of experience in an ambulatory or acute care setting, home health or public health.
• Excellent communication skills, must be able to work with changing priorities.
• Must be able to interact with individuals of all cultures and levels of authority.
• Requires excellent organizational, problem solving and critical thinking skills.
• Experience with chronic health conditions, knowledge of Managed Medicaid preferred.
• Majority of interactions are telephonic and require sitting for an extended period of time

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

Tasks, duties, and responsibilities, as listed in this position description, are not exhaustive. The Organization, at its sole discretion and with no prior notice, may assign other tasks, duties, and job responsibilities. Equivalent experience, skills and/or education will also be considered, so qualifications of incumbents may differ from those listed in the Position Description. The Organization, at its sole discretion, will determine what constitutes as equivalent to the qualifications described above. Further, nothing contained herein should be construed to create an employment contract. Occasionally, required skills/experiences for jobs are expressed in brief terms.