RN Case Manager

2 days ago

Bend, Oregon, United States Mosaik Medical Full time
Job Title: RN Case Manager

Mosaic Community Health is seeking a skilled RN Case Manager to join our team. As a RN Case Manager, you will be responsible for providing comprehensive case management services to at-risk or high-risk patients.

Key Responsibilities:
  • Assess, plan, implement, coordinate, monitor, and evaluate patient care plans to optimize health status and minimize hospital utilization.
  • Collaborate with quality, value improvement, and population health staff to identify high-risk patients and develop individualized care plans.
  • Implement evidence-based interventions and approved protocols for chronic conditions, and integrate clinical guidelines and preventive guidelines into patient care plans.
  • Provide follow-up with patients and families regarding transitions of care, including medication reconciliation, timely follow-up appointments, patient education, and coordination of care.
  • Communicate and coordinate with internal and external care teams to ensure quality patient care and address barriers to care.
  • Assess health, educational, and psychosocial needs of patients and families, and develop, implement, and evaluate care plans.
  • Utilize behavioral strategies to provide patient self-management support and empower patients and families to build capacity for self-care.
  • Work closely with primary care teams to coordinate services and optimize patient care.
  • Utilize available tools to facilitate close monitoring of high-risk patients and intervene early during acute exacerbations.
  • Document all interactions in the EHR in a timely, thorough, and accurate manner.
Requirements:
  • Superior nursing process skills and critical thinking and problem-solving skills.
  • Excellent written, verbal, telephone, and interpersonal communication skills.
  • Understanding of patient and family-centered care concepts and strong organizational skills.
  • Familiarity with patient interaction on the telephone and basic typing and computer skills.
  • Preferred: EHR experience, fluency in Spanish, involvement with quality improvement processes, and knowledge of health insurance plans and regulatory requirements.
About Mosaic Community Health:

Mosaic Community Health is an innovative health system that pioneers unique and creative ways to provide and improve patient access to healthcare. We focus on a holistic approach to patient care by incorporating behavioral health, pharmacy, and nutrition support to serve patients in the most meaningful way.

We offer a dynamic team-based environment and a lifestyle that improves lives, including yours. Join us in our mission to provide exceptional patient care and make a difference in the lives of our patients and communities.

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