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Registered Nurse Care Coordinator
2 months ago
Position Overview
Full-time Ambulatory RN Care Manager
Location: Hyde Park, NY
Work Schedule: 40 hours per week, 8-hour shifts, Monday to Friday, between 8:00 AM and 4:30 PM.
Role Summary:
The Ambulatory RN Care Manager operates under the direct supervision of the Manager of Ambulatory Care Management. This role involves an expanded nursing function aimed at coordinating and delivering care management services to patients across various risk levels. The RN collaborates with primary care providers across multiple practice locations to ensure adherence to clinical guidelines and to coordinate services tailored to patients' healthcare requirements. The care manager integrates patient needs, educational pathways, clinical guidelines, and diagnostic assessments to formulate personalized care plans.
Key Responsibilities:
- Conduct assessments, plan, implement, coordinate, monitor, and evaluate all options and services aimed at optimizing the patient's health status. Evaluate healthcare, educational, and psychosocial needs of patients and their families.
- Utilize evidence-based clinical and preventive guidelines, protocols, and metrics to create patient-centered treatment plans. Enhance quality and efficiency in healthcare delivery for the served population. Employ established educational pathways to ensure comprehensive and consistent condition management education for patients.
- Assess patients at the point of disposition to optimize individualized care plans. Identify the target population and stratify the risk of all patients to prioritize needs and direct interventions. Capable of providing Transitions of Care.
- Develop personalized care plans in collaboration with patients, fostering a team approach by working closely with patients, families, primary care providers, and other healthcare team members to ensure service coordination.
- Demonstrate the ability to work independently and be directly accountable for outcomes. Collaborate with primary care providers to enhance adherence to evidence-based clinical guidelines and promote best practices by initiating or adjusting therapies as directed, ensuring appropriate follow-up and monitoring as necessary. Facilitate and coordinate laboratory and diagnostic tests for all condition management programs.
- Evaluate patient progress towards desired health outcomes and adjust care plans accordingly for optimal results.
- Collect, document, and analyze data (pre-visit planning) and communicate results/documents as required for care management programs.
- Maintain patient confidentiality in all activities related to care management programs.
- Identify issues, propose process improvement strategies, and assist the care management team in quality improvement initiatives.
- Collaborate with other disciplines at practice sites to identify operational challenges and performance improvement needs.
- Participate in professional and nursing continuing education programs as necessary to support care management initiatives and professional growth. Review current literature on effective teaching and learning strategies and incorporate appropriate techniques into patient education sessions.
- Provide support to other members of the care management team.
- Perform additional duties as required or assigned based on operational needs.
- Fulfill all compliance responsibilities related to the position.
- Perform other duties as assigned.
Additional Information:
Requirements: Ability to travel and manage fluctuating work hours. A current valid driver's license and access to a reliable vehicle are necessary for home visits. Excellent listening, verbal, written, and critical thinking skills are essential.
Experience: Minimum of three years in a relevant field.
Preferred Qualifications: Familiarity with insurance coverage, experience in ambulatory or managed care settings, and prior case or care management experience.
Education:
Essential: Bachelor's Level Degree.
Working Conditions:
Manual: Minimal manual skills/motor coordination and finger dexterity required.
Occupational: Minimal potential for occupational risk.
Physical Effort: Sedentary/light effort, may exert up to 10 lbs. of force.
Physical Environment: Generally pleasant working conditions.
Company: Nuvance Health
Department: Care Management
Exempt Status: Yes
Salary Range: $72.83 Hourly
Nuvance Health is an equal opportunity employer. Qualified applicants are considered for positions without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status, or any other classification protected under applicable Federal, State, or Local law.
We strive to provide reasonable accommodations to qualified applicants with disabilities unless doing so would impose an undue hardship on our operations. If you require assistance to complete this form or participate in an interview, please contact Human Resources for reasonable accommodation requests only. Please provide all requested information to ensure consideration for current or future opportunities.
