What are the responsibilities and job description for the TCHP Care Manager-RN - Hyde Park Internal Medicine/Family Medicine - Full Time - Days position at The Christ Hospital?
Job Description
The primary duties of this position involve facilitation of continuity of care across the healthcare continuum. This role acts as a navigator and advocate for better health outcomes for patients served by the primary care physician. The Care Manager is responsible for managing high risk patients with multiple comorbidities or at high risk for hospital admission or readmission. This will include developing and monitoring health promotion, disease management, care coordination and utilization management. The Care manager will develop care plans in conjunction with the care team to implement interventions that assist moving the patient toward optimal health. The Care manager will facilitate care transitions after a hospital admission to ensure the patient has a seamless experience and well coordinated care.
Responsibilities
Care Management - Work with all clinical teams as a resource on care management
- Identify targeted patient populations that would benefit from care management.
- Pre-visit planning workflow to ensure care completion prior to visit whenever possible
- Use of efficient, accurate point of care reminders for evidence based care
- Coordinates patient care services for selected patients across the continuum of care through collaboration with the patient and family and health care providers in achieving optimal patient outcomes
- Communicate with patients after hospitalizations to schedule appointments, assist with medication education, review after visit summary and provide the patient with a point of contact.
- Collaborate with the Care Team and follow up appropriately to ensure smooth transition of care for patients treated in a facility (inpatient or emergency department), by a specialty physicians, or by another health care provider
- Involve patients in activities to improve their health (patient engagement);
- Educates patients about self-management tasks they can undertake to gain greater control of their health status.
- Conducts health teaching and health counseling to patients and / or their families.
- Identify barriers preventing patients from achieving optimal health, problem solve and plan with the Care Team and outside resources to overcome.
Clinical quality and performance
Provide the highest level of customer service to achieve the goal of “putting patient’s first”.
Information Technology :
All other duties as assigned.
Qualifications
KNOWLEDGE AND SKILLS :
Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position.
EDUCATION : Registered Nurse
YEARS OF EXPERIENCE : Minimum of 3 years experience
REQUIRED SKILLS AND KNOWLEDGE :
Autonomous
Excellent problem solving and critical thinking skills
Ability to prioritize work, and manage multiple demands
Knowledge of basic computer functions
Ability to communicate effectively with others, both written and verbally
Ability to work both with and for the team
Ability to show respect and sensitivity to cultural differences in both employees and patients
Knowledge and support of organization’s goals and values
LICENSES & CERTIFICATIONS :
Must be current Registered Nurse Licensed in state of Ohio
About Us
For more than 130 years, The Christ Hospital been the beacon for exceptional healthcare in the Greater Cincinnati community. We're industry pioneers, always pushing the boundaries and reimagining the future of healthcare.
Our culture promotes collaboration, diversity and innovation. Together, as a team, we work tirelessly to enhance healthcare quality, accessibility and safety.
