Care Manager I

About the role

The Care Manager I is an integral member of the office care team. They provide care management and care coordination for patients experiencing a transition of care, undergoing treatment, or with moderate to complex illnesses.

Responsibilities

• Collaborates with members of the health care team and patients to ensure the delivery of quality, efficient, patient-centered, and cost-effective healthcare services.
• Affirms patients in managing their health by providing self-management support and patient education.
• Empowers patients to avoid hospitalization and emergency room visits, especially in specialty populations.
• Assesses, plans, implements, monitors, and evaluates individualized patient care to optimize health status.
• Serves as an active member of the office-based care team and supports the identification and referrals of eligible patients for care management support.
• Engages hospitalized patients to facilitate the transition of care and provides support and education to prevent further readmissions.
• Coordinates care and services for selected member populations across the continuum of care, promoting effective utilization and monitoring of health care resources.
• Maintains the ability to utilize guidelines and standards of care for managing chronic diseases.
• Utilizes relevant computer information support, including the EMR and other care management and clinical IS systems, to complete clinical care tasks and performance reporting.
• Works with patients and providers to customize services that meet their needs and work within their benefits.
• Researches and facilitates services for patients outside of their benefits while coordinating with community resources.
• Provides feedback on the orientation process for new Care Managers.
• Evaluates and manages day-to-day workflow to increase efficiencies.
• Attends required meetings and training, and participates in committees as requested.
• Assists with special projects and performs other duties as assigned.

Qualifications

• Bachelor of Science degree in Nursing (BSN) or Associates Degree in Nursing with extensive nursing experience.
• Completion of self-management support training preferred.
• Valid, unrestricted RN license in the State of Michigan; valid CPR certification.
• CCM certification preferred.
• 3-5 years of experience with primary care/ambulatory care, home health agency, skilled nursing facility, or hospital medical-surgical, within the past five years.
• Care management experience preferred.
• Experience as a participant in continuous quality improvement preferred.