The Manager, Licensed Care (LCM) coordinates screening and provides intervention of patients with identified complex chronic care needs, and connects patient needs with care management program resources. The LCM provides program guidance and leadership, and ensures patients receive the best possible care.

Essential Duties & Responsibilities:

• Identifies, tracks and manages care for the highest risk patients
• Conducts initial care coordination screening eligibility and performs comprehensive risk assessment
• Oversees in the development and implementation of an integrated patient care plan for each of the highest risk patients.
• Ongoing clinical assessment, monitoring and follow up for the high-risk patients
• Utilize standing orders and clinical orders for chronic disease management within scope of clinical practice
• Assesses psychological needs and ability to benefit from community resources and referrals to outside agencies/programs when appropriate
• Promotes clear communication amongst a care team and treating clinicians by ensuring awareness regarding patient care plans.
• Performs medication review, reconciliation and coordination with a licensed professional for medication adjustment
• Participates in the evaluation of the care management programs
• Collaborates and participates in the selection, development and maintenance of patient education materials related to healthy lifestyle changes and specific disease management topics.
• Makes home visit to perform comprehensive HRA to determine level of care coordination needs
• Assists in the maintenance of the patient’s health, wellness and prevention of secondary disease complications by providing education, counseling and support
• Handles protective health information in a manner consistent with the Health Insurance Portability and Accountability Act

Qualifications:

Education and/or Experience:

• Current Illinois licensure as a professional nurse (RN) or Clinical Social Worker (LCSW) required.
• Minimum of three years clinical experience with at least one year in disease or care management, required.
• Experience with EMR systems required; Centricity experience desired.
• Proficiency in Electronic Health Record, Microsoft Word and Excel

Professional Characteristics

• Displays strong management and organizational skills in a high intensity, patient focused work environment.
• Strong oral/written communication skills a must.
• Strong time management and organizational skills in a high intensity work environment required.
• Strong interpersonal, organizational, problem solving, and customer service skills required.
• Ability to work in a self-directed environment with the ability to network, organize and coordinate.

• Adept at diagnosing problems and creating treatment plans for patients.
• Excels in communicating sensitive and or adverse information.
• Sound judgment and expert decision-making abilities.

• Flexibility with managing multiple projects.
• Attention to detail and a dedication to accuracy.
• Ability to handle confidential information in a professional & discreet manner.