Watkinsville, Georgia
R.N. Care Manager Job Opening in Watkinsville, Georgia - JOB SUMMARY:
The role of the Clinical Case Manager is to coordinate continuity of care for patients often as a liaison between the patient?s family and healthcare organization, ensuring that the proper treatment is administered at the appropriate time to maximize health and well-being while also minimizing the need for hospitalization. The Case Manager strives to promote self-managed care and the use of healthcare resources in the most cost-effective way possible, working with patients of all ages and conditions, but primarily focusing on a specific population. The individual in this position has responsibility in coordination with the patient?s primary care physician for overseeing the clinical plan of care to conform to evidence-based practice and regulatory requirements. This position integrates care coordination, utilization management, and discharge planning.
DUTIES AND RESPONSIBILITIES:
Identifies members appropriate for Case Management by use of targeted chronic conditions, level of care, and recognition of member?s disease specific and preventative measures, knowledge base or deficits in monitoring health, wellness and chronic conditions.
Performs telephonic care or meets patient at home or physician?s office to collect in-depth information regarding the member?s situation, functioning, and needs assessment in order to develop a comprehensive Plan of Care and provide interventions and education for the management of their health, wellness and chronic conditions.
Coordinates with facility and providers to improve care transitions.
Implements a plan of care and monitors the plan of care to determine if the goals are being met on an ongoing basis to evaluate for needed changes and updates the plan of care accordingly. Closes the plan of care when complete.
Collaborates with the Provider or their designee to address the plan of care from an integrated approach, overcome barriers and improve outcomes.
Reviews and analyzes clinical indicators and whether there is any ?gap? in wellness, preventive and disease specific quality measures. Works with patient to improve quality outcomes.
Identifies and reports quality of care issues to the CIN Manager of Care Management.
Promotes the mission, philosophy, goals, and policies of the company through staff education.
Completes clear and concise documentation in Care Management programs.
Participates in Care Conferences.
Guide and direct Care Coordinators in patient interaction and physician education.
Maintain personal professional development.
Comply with all departmental policies and procedures.
Participate in departmental and company in-services as appropriate
Performs other duties as assigned.
QUALIFICATIONS:
Registered Nurse (RN) with a current and active nursing license to practice in the state assigned or maintain a compact license.
CCM highly desirable
3 years of various clinical experiences preferred
Ability to utilize nursing skills to understand and coordinate care of those members that are significantly physically compromised by their illness and/or disability.
Accountable and autonomous.
Ability to handle multiple demands of diverse workload and prioritizes critical issues.
Ability to effectively communicate verbally and in writing.
Ability to build effective collegial relationships.
Ability to influence and effect change.
Ability to analyze and think critically.
Possesses current knowledge of disease pathophysiology, psychosocial issues, and treatment.
Good time management skills.
Positive, service-oriented attitude. High level of integrity.
Computer literate
Must maintain valid driver?s license and vehicle.
Ability to obtain and utilize sensitive information discreetly and objectively
Job Type: Full-time
Required education:
Associate
Required experience:
nursing: 3 years
Required license or certification:
Registered Nurse (RN)
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