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Lead Care Manager
2 months ago
Complete Health is seeking a highly skilled and experienced Lead Care Manager - RN to oversee the Chronic Care Management (CCM) program and staff in their assigned Care Pod(s).
Key Responsibilities- Provide clinical and administrative oversight, support, and training to assigned Care Pod staff, including RN Care Managers, LPN Care Managers, Care Coordinators, and Patient Advocates.
- Assist the Nurse Manager of Care Management in clinical oversight, training, and documentation review.
- Collaborate with primary care providers and the Nurse Manager of Care Management to determine initial and subsequent patient acuity designations and patient assignments to the appropriate Care Pod team member.
- Oversee that each CCM patient receives a thorough assessment and Care Plan initially, annually, and as their condition requires, and that quality measures and gaps in care are being addressed by the Care Pod Staff.
- Perform regular audits to ensure CCM Care Pod staff accurately assesses and documents calls, cases, updates Care Team and medication lists, closes quality gaps, and brings additional medical concerns to the primary care provider.
- Provide reports and feedback to the Nurse Manager of Care Management for assigned Care Pod(s).
- Assist the Transitional Care Management (TCM) team and ensure TCM patients are followed by the appropriate CCM staff as they transition from TCM to CCM.
- Assign responsibilities to RNs, LPNs, or other well-experienced healthcare professionals, with close monitoring of their performance and involvement.
- Triage, coordinate, document, communicate, and track patient calls, cases, and records for a panel of high-acuity Traditional Medicare and Medicare Advantage Plan patients in the CCM program.
- Ensure patients with chronic conditions in their care are provided with CCM services in an appropriate and timely manner.
- Current Licensed Registered Nurse (RN) with a Bachelor's Degree and 3 years of related care management, medical clinical experience, and/or training.
- Experience in social and care management services and patient engagement.
- Knowledge of hospitals, specialists, and ancillary health services throughout the assigned community.
- Strong computer skills and proficiency in Microsoft Office products and internet software.
- Able to effectively utilize an electronic health record to perform and document all patient encounters.
- Athena EHR experience preferred.
The position requires climbing, stooping, kneeling, crouching, reaching, standing, lifting, grasping, feeling, talking, hearing, repetitive motions, and finger use. Pushing and pulling are occasionally required. Use of a computer, keyboard, and telephone along with various office machines is an essential part of the job.