About Job

Job Description

Position Title: RN Care Manager

Position Reports to: Chief Medical Officer

JOB STATEMENT/SUMMARY

The RN Care Manager oversees the delivery of care management services for Alliance Family Health System (AFHC). Care management services are designed to improve quality of life and health outcomes and include preventive services (e.g., annual healthcare visits) and continuity of care services (e.g., follow-up after hospitalization and emergency department visits).

ESSENTIAL FUNCTIONS & RESPONSIBILITIES OF THE POSITION

· Oversees the care team, ensuring they are properly trained for care management roles and compliant with all responsibilities of their work.

· Observes the provision of care management policies, protocols, workflows, and services and assists with suggestions and recommendations for improvement of the care management program related to the delivery of services.

· Collaborates with providers and leadership to develop and disseminate clinical guidelines and protocols.

· Responsible for reviewing, delegating, and closing out provider tasks following established guidelines and protocols.

· Assists in the implementation and daily management of quality care incentive programs, accountable care organization requirements, Patient Centered Medical Home, and other quality improvement and community outreach programs as identified by the organization.

· Works with clinical management to provide annual wellness visit services to identified patients, facilitating successful completion of care management duties associated with the patient encounter.

· With care team, provides care management services to patients in a manner that encourages full participation in preventive services and continuity of care services.

· Uses best practices in documentation within the electronic health record, summarizing and documenting pertinent information and verbal discussions with the patient/patient's legally appointed representative, family, practitioner, other health care provider or healthcare staff, when providing care management services.

· Evaluates use of care management resources (e.g., staff, facilities, equipment, etc.) and assist with development and implementation of methods that increase effective and efficient use of those resources.

· Cooperates with leadership to ensure care team work schedules are appropriate based on workload, space, equipment availability, demand, and other factors.

· Oversees the planning, organization, and implementation of in-service training for care management staff to ensure necessary competencies and certifications are achieved and maintained.

· Monitors performance of care management duties within clinical records via audits, insurance gap reports, preventative care status updates, etc.

· Recognizes concerns in patient quality of life and health outcomes, care management functions, etc. and reports those issues to the CMO.

· Operates within the scope of clinical licensure and care management roles, policies, protocols, and workflows.

Performs other duties as assigned by the CMO.

JOB REQUIREMENTS AND PREFERRED QUALIFICATIONS

· Electronic Health Record

· Professionalism

· Collaboration

· Communication

· Facilitation

· Analysis

· Education

· Critical Evaluation

· Leadership

Five (5) years of clinical experience is preferred. Minimum requirement is a current (unrestricted) RN licensure in OH.

Alliance Family Health Center believes our employees should continually develop their knowledge, skills, and abilities. All employees are expected to participate in AFHC-sponsored professional development activities (e.g., education programs, in-service meetings, training workshops, coaching, etc.) and remain current in their role capacity through individual development activities (e.g., reading current literature, participating in webinars, attending local and/or regional workshops, etc.).

This job directly supervises the Care Team .

Job Type: Full-time

Pay: $60,000.00 - $75,000.00 per year

Benefits: