RN Care Manager - GBMA
Greater Baltimore Medical Center - Towson, MD
posted 4 days ago
About the position
The RN Care Manager is committed to comprehensive quality care management and coordination of clinical activities for primary care patients. This position focuses on promoting early intervention for complex patients and co-developing a plan of care that prevents unnecessary complications and negative patient outcomes. The RN Care Manager promotes population management through effective education, self-management support, goal setting, and timely health care delivery. This includes communicating with patients and their families concerning the progress of patient goals and ongoing care needs, developing and monitoring care management processes, and support of primary clinical team efforts. The Nurse Care Manager develops and maintains collaborative working relationships with all team members including Practice Manager, Lead Physician, and Care Coordinator, and Behavioral Health Care Manager to best serve the needs of the identified patient panel and primary care teams. The RN Care Manager will serve as a clinical resource to the Medical Assistant staff and Practice Manager.
Responsibilities
- Assesses patients within a defined caseload to identify clinical/medical needs or issues, financial resources, and care goals.
- Actively manage assigned panel of chronic care patients (high acuity/complex) by developing relationships with the patient as an integral member of the team.
- Execute standing orders for tests and preventive services.
- Manage many aspects of the patient's care including referrals to specialists, hospitalizations, ER visits, and ancillary testing.
- Prioritizes care management activities in order of greatest patient need and system need.
- Develops and implements plan for assessment, education, goal setting and tracking outcomes.
- Reports at APC meetings providing provider care transformation metrics.
- Participates in practice strategy and for performance improvement and innovation.
- Collaborate with MIS team to facilitate registry reporting at the site and documentation of Evidence Based Guidelines.
- Responsible for working with patient and patient's care team to coordinate change readiness, needs assessment and develop an individualized care plan.
- Collaborates with the patient, providers, and other care team members in assessing the patient's progress toward individual health care goals.
- Oversees the development, and adoption of patient self-management educational resources used by the primary clinical teams.
Requirements
- Registered Nurse license required.
- Bachelor's of Science in Nursing preferred.
- Extensive knowledge of disease management including diagnostics, treatment and prognosis, community resources, and levels of care.
- 1-2 years of clinical experience preferred.
- Relevant experience in coordination of community resources, care management of diverse patient populations, and familiarity with care in an ambulatory setting.
- Working knowledge of Care Management models especially in the State of Maryland.
Nice-to-haves
- Clinical Assessment, interviewing and patient education skills.
- Skill in oral and written communication to address inter- and intradepartmental concerns.
- Demonstrated skill in problem solving using available resources in innovative ways.
- Computer and personal productivity skills to enable effective job performance.
- Maintains knowledge of professional standards of practice through participation in continuing education.
Benefits
- 401k
- health_insurance
- dental_insurance
- vision_insurance
- paid_holidays
- tuition_reimbursement
- professional_development
