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5 days ago
Community Health Systems, Inc. is seeking a skilled RN Case Manager to join our team. As a RN Case Manager, you will work effectively with and as part of the ECM Provider to provide high-quality, effective care management to Enhanced Care Management (ECM) members. This role involves working collaboratively as part of the ECM Care Team, members and families, and other professionals, in addition to working collaboratively with the designated PCP care team.
Responsibilities- Responsible for primarily working with a minimum caseload of 40 ECM Members with high risk/complex medical needs.
- Responsible for completing medication reconciliation in collaboration with pharmacy/PCP as available for all ECM-enrolled Members.
- Engages Members and supports/encourages Member activation towards achievement of health goals via face-to-face or telephone interactions;
- Provide formal and informal training and support for ECM members on medical conditions, including treatments and evidence-base for treatment.
- Represents the ECM Provider as the lead member when necessary.
- Responsible for promoting a collaborative and effective working environment within the ECM by engaging in evidenced-based communication strategies (such as Motivational Interviewing) when discussing responsibility/sharing of tasks, effectively resolving conflicts as they arise, and collaborating on Member case discussions;
- Tracks medical and behavioral health outcome measures in the web-based care management platform or equivalent platform;
- Tracks and assures required assessments and screenings are performed,
- Provides Member and family education about chronic medical and behavioral health conditions to improve health literacy;
- Gathers input from other ECM Care Team members to prioritize Member cases for systematic population/caseload review;
- Consults with the ECM Care Team members about clinical concerns or questions, and provides educational training on chronic disease states, prevention, treatment, medications and healthy living;
- Works with Members to identify health/wellness goals, and incorporates these goals into Health Action Plans/Shared Care Plan that facilitate communication among Members and Providers;
- Coordinates physical care management and care coordination relationships with external healthcare Providers;
- Receives, identifies and follows-up treatment and medication alerts;
- Ensures smooth transitions of care;
- Reviews health assessments (splits role with BHCM) upon completion by other care team members.
- RN unrestricted license required.
- A valid California driver's license, a reliable car, and valid automobile insurance are also required.
- Three (3) or more years of care management experience in a health care delivery setting.
- Experience in a Health Care Organization or experience in Managed Care setting preferred.
- Minimum 1-year clinical experience in an acute care facility, skilled nursing facility, home health or clinic setting preferred.
- American Heart Association BLS certification required
- Must maintain continuing medical education requirements for licensure
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