Manager Clinical Case for Patient Advocacy and Care Coordination

Job Overview

We are searching for a dedicated and experienced Clinical Case Manager to join our dynamic team, where you can significantly influence the health outcomes of our community. This position is ideal for individuals who are committed to delivering exceptional care and support to underserved populations, making a meaningful impact in patients’ lives while working collaboratively with a multidisciplinary team of healthcare professionals and patient families.

Key Responsibilities

• Act as a patient advocate, facilitating their navigation through the healthcare system.
• Engage in quality improvement projects aimed at enhancing patient outcomes, including HEDIS, Value-based care, and PCMH initiatives.
• Identify and address care gaps by coordinating services and follow-up for patients.
• Ensure continuity of care by collaborating with external healthcare facilities regarding hospital admissions, discharges, and specialty referrals.
• Lead care transitions, offering support to patients and their families post-hospital discharge, emergency visits, and specialist referrals.
• Co-manage care for high-risk patients, particularly those with multiple chronic conditions or a high likelihood of readmission, in collaboration with the Clinical Care Management team.
• Address Social Determinants of Health (SDOH) by assessing screenings and providing community-based resources as needed.
• Maintain effective communication with the healthcare team through thorough documentation in patient charts and participation in team meetings.
• Contribute to data collection, health outcomes evaluation, clinical audits, and assessments related to Patient-Centered Medical Home initiatives.
• Assist in the development of clinical tools, forms, and procedures to improve patient care and operational processes.
  
  

Required Skills

• Active LPN certification (CMA experience is advantageous).
• Prior experience of 1-2 years in case management or a related healthcare role.
• Proficiency with electronic medical records (EMRs), with familiarity in Athena being a plus.
• Proven track record of collaborating with medical providers (Physicians, Nurse Practitioners) in developing care plans.
• Experience working with insurance companies to secure patient data and resources.
• Capacity to manage a caseload of approximately 300 patients monthly.
• Strong communication abilities for educating patients and engaging with their families/support networks.
• Proficiency in Microsoft Office applications (Excel, Word) and a solid grasp of computer skills.
• Self-motivated, reliable, and detail-oriented individual.
• Effective problem-solving capabilities with the readiness to escalate concerns to providers when necessary.
• Exceptional interpersonal and customer service skills, promoting a positive team environment.
• Ability to thrive in a fast-paced setting and manage stress and conflicts effectively.
• Commitment to confidentiality and adherence to relevant policies and procedures.
  
  

Qualifications

• Active LPN certification required.
  
  

Career Growth Opportunities

This role offers a pathway to professional development through active participation in quality improvement initiatives and involvement in significant healthcare projects that directly impact community health.

Company Culture And Values

We pride ourselves on fostering a collaborative and supportive work environment that emphasizes teamwork among healthcare providers and a shared commitment to enhancing community health outcomes. Join us in making a difference!

Employment Type: Full-Time