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 manage their health by providing targeted interventions to avoid hospitalization and emergency room visits.
• Assesses, plans, implements, monitors, and evaluates the delivery of individualized patient care with the goal of optimizing the patient's 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 assist with the transition of care and provides support and education to avoid further readmissions.
• Coordinates the care and services of selected member populations across the continuum of care, promoting effective utilization and monitoring of healthcare resources, and assumes a collaborative role with all members of the healthcare team to achieve optimal clinical and resource outcomes.
• Maintains the ability to utilize guidelines and standards of care for management of chronic diseases.
• Utilizes relevant computer information support including the EMR and any other care management and/or clinical IS systems needed to complete the tasks of clinical care and performance reporting.
• Works with patients and providers to customize services that best meet the needs of the patient and work within their benefits.
• Researches and facilitates services for patients outside of their benefits while utilizing community services and resources.
• Provides patient-specific feedback to providers and clinical team.
• Provides face-to-face and telephone interactions with patient population.
• Attends required meetings and training, and participates in committees as requested.
• Assists with special projects and performs other duties as assigned.

Qualifications

• Education: Bachelor of Science degree in Nursing (BSN) or Associates Degree in Nursing with extensive nursing experience. Completion of self-management support training preferred.
• Credentials/Licenses: Valid, unrestricted RN license in the State of Michigan; valid CPR certification. CCM certification preferred.
• Experience: 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 participant in continuous quality improvement preferred.

Skills

• Knowledge of patient care procedures and organizational policies related to position responsibilities.
• Knowledge of chronic conditions, evidence-based guidelines, prevention, wellness, health risk assessment, and patient education.
• Excellent assessment and triage skills (per specialty population expectations).
• Understands chronic disease management strategies and is able to implement appropriate protocols and guidelines.
• Proficient/knowledgeable in medical terminology.
• Proficient in operating a standard desktop and Windows-based computer system, including but not limited to, electronic medical records and other care management and/or clinical IS systems, email, e-learning, intranet, Microsoft Word and Excel, and computer navigation needed to complete the tasks of clinical care and performance reporting.
• Excellent communication skills in both written and verbal forms, including proper phone etiquette.
• Ability to speak before groups of people.
• Ability to work autonomously and collaboratively in a team-oriented environment; courteous and friendly demeanor.
• Ability to work effectively with various levels of organizational members and diverse populations including IHA staff, providers, provider leadership, patients, family members, insurance carriers, vendors, external customers and community groups.
• Good organizational and time management skills to effectively juggle multiple priorities and time constraints.
• Ability to exercise sound judgement and problem-solving skills.
• Demonstrated skills with influencing and negotiating individual and group decision-making.
• Ability to handle patient and organizational information in a confidential manner.
• Knowledge of the compliance and quality aspects of clinical care and patient privacy and best practices in medical office operations.
• Ability to travel to other office/practice sites and meeting and training locations.
• Successful completion of IHA competency-based program within introductory and training period.

Requirements

• Physical activity that often requires keyboarding, phone work and charting.
• Physical activity that often requires extensive time working on a computer.
• Physical activity that often requires handling and lifting patients walking, standing, bending, stooping, reaching, climbing, kneeling and/or twisting.
• Physical activity that often requires lifting, pushing and/or pulling up to 20 pounds.
• Specific vision abilities required include close vision, depth perception, peripheral vision and the ability to adjust and focus.
• Manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment.
• Must hear and speak well enough to conduct business over the telephone or face to face for long periods of time in English.