What are the responsibilities and job description for the Nurse Care Manager, Integra position at Care New England?
Job Summary:
The Nurse Care Manager is a vital part of the Integra team in a hybrid setting, including primary care and telephonic care. The Nurse Care Manager is responsible for providing comprehensive screenings, assessments, care coordination services, disease education, and self-management support to patients with targeted chronic health conditions. This role integrates into the office-based healthcare team to promote patient-centered care, maintain frequent contact with primary care providers and medical home team members, and actively participate in multidisciplinary patient-centered care team meetings.
Duties and Responsibilities:
Leverage EMR and chronic disease registry reporting to prioritize patient outreach and follow-up.
Provide care management services under the direction of the practice manager or provider.
Complete initial patient assessments, including comprehensive medical, psychosocial, and functional evaluations.
Educate patients about specific chronic illnesses, including pathology, signs and symptoms, complications, and medications.
Ensure screening tests and immunizations are up to date.
Use behavior change techniques, such as motivational interviewing, to establish therapeutic relationships with patients.
Develop and implement patient care plans that promote improved health outcomes and quality of life, informed by patients' goals, strengths, and barriers.
Advocate for patients to ensure timely service delivery across the continuum of care and access to community resources.
Conduct medication reconciliations and provide support to enhance medication adherence.
Collaborate with caregivers to clarify patient needs and provide support to family members.
Document activities in EMR and generate reports on service volume and effectiveness.
Utilize a multidisciplinary team approach to plan and coordinate care, including quality improvement initiatives.
Requirements:
Bachelors degree in nursing required.
3-5 years of nursing experience in acute care or skilled settings, community health, public health, chronic disease management, or community nursing.
Case management experience preferred.
Certification in Case Management required within 12 months of employment.
Active RI State Nurse License.
Care New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, and our Wellness Center, are trusted organizations fueling the latest advances in medical research, attracting the nations top specialty-trained doctors, and honing renowned services and innovative programs to engage in the important discussions people need to have about their health.
Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.
EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status
Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.
