Ambulatory Care Manager

1 week ago

Richmond, Virginia, United States Bon Secours Mercy Health Full time
About the Role

We are seeking a highly skilled Registered Nurse to join our team as an Ambulatory Care Manager. In this role, you will provide clinical care management services to identified eligible patients, coordinating care to obtain desired health outcomes, improve self-care abilities, and decrease unnecessary cost of care.

Key Responsibilities
  • Utilize Motivational Interviewing techniques to activate patients in self-management of their chronic conditions.
  • Maintain a caseload of patients according to department policies.
  • Identify, enroll, and manage patients in programs for Transitions of Care, Complex Case Management, and Chronic Disease Management.
  • Develop and implement care plans to maximize healthcare outcomes and facilitate wellness.
  • Perform medication review and teach-back to ensure patient understanding and ability to adhere to medical regimen.
  • Collaborate with PCPs, Specialists, and Hospitalists to effectively implement a patient-centered care plan.
  • Perform patient outreach according to established protocols and document in electronic medical record.
  • Identify, execute, and track needed referrals to care and community resources.
  • Provide resource management to improve care, patient experience, and reduce unnecessary cost and utilization.
  • Assist patients in advanced care planning to complete Advanced Directives.
Requirements
  • Registered Nurse with active License in State of Patient Care.
  • 2-3 years acute care, home health, or case management experience.
  • Excellent interpersonal communication and negotiation skills.
  • Strong analytical, data management, and computer skills.
About Us

Bon Secours Mercy Health is a health system dedicated to continually improving health care quality, safety, and cost effectiveness. Our hospitals, care sites, and clinicians are recognized for clinical and operational excellence.

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