RN Care Manager for Case Management

4 weeks ago

Plattsburgh, United States The University of Vermont Health Network Full time

Primary Shift: 7:a-4:p; Secondary Shift: 7:a-5:p

GENERAL SUMMARY:

The Care Manger position is an integral part of the healthcare team working closely coordinating inpatient and outpatient care and services across the continuum of care assuring and including Primary care and Specialty providers. The Care Manager utilizes his/her skills to coordinate internal and external resources to facilitate appropriate resource management of an age specific patient population which spans from newborns to geriatrics, identifying opportunities for process improvement, high risk cases and sentinel events, to the achievement of an acceptable outcome. The Care Manager’s role in data collection, analysis and summarization supports performance improvement/quality programs, risk management, clinical pathway development and outcome measurement using guidelines. They possess the ability to work independently as well as collaborate and communicate effectively with colleagues, supervisors, service delivery partners, other health care professionals and co-workers to build and maintain effective, dynamic professional team relationships. This position is an integral part of the Patient Centered Care team. The Care manager works under the supervision of the Regional Director- Patent Centered Care Management to support the objectives of UVM Health Network - CVPH and the Medical Home. Responsible to identify at-risk patients and develop plan of care based on risk and patient goals to meet individual health needs through communication and assisting with access to resources to promote quality, cost-effective outcomes across the continuum of care.

QUALIFICATIONS:

Education/Skills Required:
1. Currently licensed as a Registered Nurse in New York State required.
2. Three years of nursing experience required, CCM preferred, Discharge Planner preferred.
3. Preferred experience in ambulatory care and/or case (care) management.
4. Knowedgable in the Managed care process preffered.
5. Knowlegdable of regulatory requirements; IE: DOH, CMS,EMTALA, Joint Commission, etc.
6. Knowedgable in Medicare, Medcaid, Private insurances, etc., preferred.
7. Knowledge of electronic medical records systems; IE: Sorian, Medent, Care Navigator, EPIC, Microsoft applications, etc.
8. Ability to develop and maintain effective relationships with staff, providers, patients and external customers. Good interpersonal and communication skills.
9. Ability to understand and commit to UVM Health Network CVPH core values of teamwork, confidentiality and quality care.
. Working knowledge of medical terminology and medications required.
. Knowledge and understanding of prior authorization for DME/Medications, etc.
. Must have strong verbal and written communication skills. Must have excellent attention to detail.
. Ability to effectively manage multiple cases and projects required. Assessment, goal setting skills, project management skills, and problem solving skills required.
. Ability to make appropriate decisions with a minimum amount of supervisory direction required.
. Ability to incorporate evidence based practices required.
. Ability/experience with data collection, program management and reporting required.
As applicable, the individual has training/competency in attending to the special needs and/or behaviors appropriate to the age of the patients for which care is being provided.

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