St Joseph, MI, USA
Benefit eligible positions are those listed with 24 hours per week or more. Job Details Location: St. Joseph, MI Department: Care Management - Manager Care Management Status: Full time Shift: Day (United States of America) Hours: Monday - Friday, 8:00 am to 4:30 pm, on call coverage every 8th or 9th weekend Job Summary Assess, plan, develop and implement a care plan in order to meet the needs of a designated patient caseload. Partner with the physician(s) and provides leadership to the health care team in achieving quality outcomes for the organization, establishes best practice guidelines, and participates in all aspect of the patient centered care model. Ensure timely continuity of care, appropriate transitions for patients and their families, and provide optimal outcomes across the continuum of care. • Assess patients for health, physical, functional, behavioral, psychosocial and social needs. • Identify target goals in collaboration with patient/family and other members of the health care team. • Plan care interventions and needed resources with patient/family, health care team, payer, and community agencies to maximize the clients health care responses, quality, safety, and care experience. • Facilitate communication and coordination among members of the health care team in order to minimize fragmentation in the services provided and prevent the risk for unsafe care and suboptimal outcomes. • Collaborate with other health care professionals and support service providers across care settings, levels of care, and professional disciplines, with particular attention to safe transitions of care. • Coordinate care interventions, referrals to specialty providers, community-based support services, resources, and involved health providers across care settings • Maintain ongoing communication with the patient/family, involved health care providers, and support service providers to assure that all are well-informed on current case management plan of care and services. • Educate the patient/family and members of the health care team about treatment options, community resources, psychosocial and financial concerns, and case management services in order to make timely care-related decisions. • Ensure appropriate allocation, use and coordination of health care services and resources while striving to improve safety and quality of care and maintain cost effectiveness on a case by case basis. • Identify barriers to care and client’s engagement in own health; address barriers to prevent suboptimal care outcomes • Assist the client in safe transitioning of care to the next most appropriate level, setting, and/or provider. • Evaluate the effectiveness of the care management plan of care, resource allocation, and service provision while applying outcomes measures reflective of organizational goals, accreditation standards, and regulatory requirements. • Complete appropriate and timely documentation in the electronic medical record. • Maintains a focus on timely, high-quality customer service.Perform other duties as assigned. •Perform other duties as assigned. •Committed to the continuous improvement of the patient experience which includes patient safety, quality of care and excellent service. Adhere to the organization’s published values. Requirements Education: Bachelors: Nursing (Required), Bachelors Degree in Progress: Nursing (Required), Masters: Nursing Certifications: *RN License - State of Michigan, BCLS Certification - AHA Skills: Additional Job Details Physical Requirements: Continuously: Standing, Walking, Lifting/exerting force: 0-10 lbs., Use of hands to grasp/handle/feel, Vision, Vision-color, Hearing, Speaking Frequently: Lifting/exerting force: 11-25 lbs., Lifting/exerting force: 26-51 lbs., Bending, Squatting Occasionally: Sitting, Stoop/kneel/crouch/crawl, Climb/balance, Operating a motor vehicle • Skills: Basic computer, data entry, typing, filing and organization skills required. Excellent verbal and written communication skills, strong listening skills, critical thinking, and analytical skills. Must be committed to continuous improvement of the patient experienience which includes patient safety, quality of care, and excellent service. • Abilities: Ability to work extended hours beyond normal work schedule to include, but not limited to, evenings, weekends, extended shifts and/or extra shifts, various locations, sometimes on short notice. • Environmental Conditions: Potential exposure to fumes, dust, gases, and odors. Frequent changes in temperature may occur. Possibility of exposure to communicable diseases.