Ambulatory RN Care Manager - Southeast Michigan - Canton

Position Summary

Performs assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified High Risk members.

Affirms and develops a care plan in collaboration with the admitting, attending and consulting physician, the member and other health care practitioners.

Effectively manages members on an outpatient basis to ensure provision of an appropriate level of care, to minimize inpatient re-admissions, and to ensure that members’ medical, environmental and psychosocial needs are met across the continuum of care.

What The RN Care Manager Will Need

• Graduation from an accredited BSN Program
• Current Michigan RN license
• CPR certification
• Valid Michigan Driver’s license
• Three years acute care or case management experience
• Potential exposure to infectious disease, hazardous chemical, and blood and body fluid
• Ability to work flexible schedules

What The RN Care Manager Will Do

• Keeps member/family members or other customers informed and requests further assistance when needed.
• Demonstrates ability to follow through with requests, sharing of critical information, and getting back to individuals in a timely manner.
• Functions as liaison between administration, members, physicians and other healthcare providers.
• Interacts professionally with member/family/physicians and involves member/family/physicians in formation of the plan of care.
• Performs a Health Risk Assessment (HRA) of the member and determines an acuity score for necessary scheduled follow-up.
• Develops an outcome-based plan of care, based on the member’s input and assessed member needs.
• Implements and evaluates the plan of care as often as needed as evidenced by documentation in the member’s case file.
• Documents member assessment and reassessment, member care plans, and other pertinent information completed in the member’s medical record in accordance with Trinity Health Alliance of Michigan charting methodology, nursing standards, and company policies and procedures.
• Maintains standard workflow to meet NCQA standards alignment and manages patient caseload to meet annual contract patient care goals.