Care Manager - RN

MIDLAND COMMUNITY HEALTHCARE SERVICES, INC.

Midland, Texas

JOB DESCRIPTION

JOB TITLE:                                       CARE MANAGERS

DEPARTMENT:                               COLEMAN / WOMEN’S SERVICES / PEDIATRICS

REPORTS TO:                                  CLINIC MANAGER(S)

OES CODE:                                       29-1141.00 (Primary), 29-1141.04 (Secondary)

FLSA EXEMPTIONS STATUS:   NON-EXEMPT

JOB SUMMARY

Care Managers play an important supporting role to the patients and physicians of Midland Community Healthcare Services.  They are expected to lead the patient through their healthcare needs by providing excellent customer service while assessing, implementing, and evaluating their individual cases.  They are responsible for maintaining accurate and complete medical records of appropriate patients in a manner consistent with medical, administrative, ethical, legal, and regulatory requirements of the health care system.

JOB DUTIES

• Observe, interview, and asses referred patients to identify care needs.
• Monitor care/case managed patients in collaboration with other health care professionals.
• Be knowledgeable of current trends in nursing and case/care management, network with colleagues; participate in professional organizations or conferences to keep abreast with changes.
• Augment provider’s plan of treatment for patients by encouraging the patients to set achievable goals for themselves. Thus making the plan of treatment successful.
• Follow the guidelines of the Board of Nursing when evaluating standards of nursing practice in specialty areas such as pediatrics, geriatrics, obstetrics and gynecology.
• Assists patients in goal setting based on information gathered by observing, and interviewing patients, or by monitoring or analyzing their records.
• Make recommendations physicians, other health care providers, insurance companies, patients, or health care organizations to improve patient care.
• Identify training needs or conduct staff training sessions as needed in regards to care management.
• Assist in leadership opportunities related to clinical staff under the direction of Clinic Manager.
• Assist management in implementing initiatives vital to the operation of MCHS and the success of its mission.
• Educate patients with regard to treatment procedures, medications, diets, and providers instructions related to care/case management
• Follow up on patient calls, lab results, referrals, prescription request and questions related to Care/Case management.
• Consult and coordinate with healthcare team members to assess, plan, implement, or evaluate care plans related to Case/Care management.
• Schedule patient referrals and educate patient as to why a referral is needed as well as the referral process. This is collaboration with Provider and Referral Coordinator.
• Review records for completeness, accuracy and compliance with company, state, and federal regulations.
• Assist in quality improvement, auditing, safety, and compliance measures of the organization.
• Follow Primary Care Medical Home standards in relation to patient care and interaction.

• Performs other duties as assigned by the Clinic Manager.

SUPERVISORY RESPONSIBILITIES

• Indirect Supervision of nurses and medical assistants.

CRITICAL SKILLS AND ABILITIES

• • Customer Service Oriented.
  • Oral Comprehension, Expression, Recognition, and Clarity.
  • Written Comprehension and Expression.
  • Computer & Technology Skills - The ability to navigate and utilize Microsoft Office, and the ability to learn to navigate and utilize proprietary medical software packages.
  • Time Management – The ability to prioritize tasks in order to best serve the patient and the flow of the clinic.

• Cultural Competency – the ability to deal with people of various cultures and social status, as well as outside entities.

QUALIFICATION REQUIREMENTS

• • Associates Degree in Nursing or Bachelors of Science in Nursing, required.
  • Texas Board of Nursing License, in good standing is required.
  • Current CPR Certification is not required.
  • 3 years of
    customer service experience preferred.
  • 3 years of supervisory experience, preferred.
  • No felony results on a criminal background screening.

• Drug Screen Test with a negative result.

WORK ENVIRONMENT/CONDITIONS

BBP Class II:  This position has a potential for some exposure-prone duties. These employees will still receive basic personal protective equipment training, basic bloodborne pathogen standard training, and safety precautions. Employees in this class are still to be offered vaccinations provided by Midland Community Healthcare Services.

Physical Demand:  Ability to interact with patients and operate office equipment for patient services.  Employees will need the ability to lift a minimum of 25 lbs, or more, independently as necessary.  Vision abilities are required to read and verify patient information, to read information on medical records, and the read information on computer systems.  Writing, speaking, and typing abilities are required in order to interview and triage the patient then document information in the paper and electronic medical charts. Ability to pull, push, lift, and manipulate equipment and files. The ability to move freely about the front office and medical record areas in order to perform the job duties is required.  In compliance with EEOC 29 CFR part 1630, reasonable accommodations will be made for those employees with disabilities in order to assist them in performing the job duties and demands, provided it does not constitute undue hardship upon MCHS.

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Employee                                                                                        Date