This site uses cookies. To find out more, see our Cookies Policy

Care Manager - RN - CIN * Days - 40hrs/wk in Grand Rapids, MI at Metro Health

Date Posted: 2/4/2018

Job Snapshot

Job Description

General Summary:

Under the direction of the PHO Director, the Care Manager - RN provides care management services to adult and pediatric patients in an ambulatory setting. The Care Manager - RN performs clinical assessments and therapeutic interventions for complex patients with multiple chronic conditions and comorbidities. In addition, this position serves as community resource expert and care coordinator across the continuum of care. Furthermore, the Care Manager - RN optimizes care by engaging patients in the principles of self-management, goal setting and continuous improvement. This integral role expands primary care’s scope of practice by focusing on patient’s biopsychosocial needs to ensure the delivery of comprehensive, efficient and quality care.
 
Essential Functions and Responsibilities:

  1. Receives and acts on referrals for moderate and complex patients through risk stratification, registries and provider referrals
  2. Assesses patients’ mental health and biopsychosocial needs through standardized assessments
  3. Recommends treatment plans based on evidence based guidelines
  4. Educates patients on preventive health, chronic illness and recommended treatments
  5. Provides care coordination and follow-up for chronic medical conditions across the continuum of care
  6. Follows patients longitudinally to evaluate treatment goals
  7. Advocates for patients and family while maintaining professional boundaries
  8. Educates and supports patients in the use of self-management techniques and develops action plans to encourage self-care
  9. Facilitates transitions of care for admitted and discharged patients from the hospital or emergency department to ensure continuity of care
  10. Consults with members of the care team throughout the continuum on treatment plans and follow-up care 
  11. Participates in process improvement activities to enhance primary care services and workflow
  12. Offers group education classes for patients with chronic conditions
Category: Nurse, Health Care

Job Requirements

Highest Education Level Preferred:Bachelors Optional Degrees And Majors:
  • Bachelors in Nursing (Preferred)
Required Licenses And Certificates:
  • RN Registered Nurse
  • And
  • RN Registered Nurse
Shift:Day On Call:No Weekends:No