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RN Care Manager - Answer Health - Full Time in Grand Rapids, MI at Rehmann, LLC

Date Posted: 11/29/2018

Job Snapshot

Job Description

Answer Health is a high performing, integrated physician network serving independent practices and providers across West Michigan. We represent approximately 200 independent practices, providing tools, infrastructure, and support required to adapt to the rapidly changing healthcare environment.  The wide range of value-added services are designed to enhance the efficiency and effectiveness of independent practices, provide quality performance support, and payer contract and operational support.

We value our people and network members, as expressed in the following statements:

Value Statement  =    AH Values

We make service our #1 priority =  committed, passionate, responsive

We are forward thinking = progressive, creative, innovative

We are dependable = reliable, trustworthy, consistent

We are a team = collaborative, supportive, respectful

We are proud of our organization = dedicated, invested, engaged

 POSITION SUMMARY

The position provides care management and care coordination for adult and pediatric patients with moderate and complex illness for services which are centralized and provided in the primary care setting for multiple practice sites.  This position partners with the primary care practices to lead care management and collaborate with patients, families, and specialists to ensure the delivery of quality and cost-efficient health care.  The position also assesses, plans, implements, coordinates, monitors and evaluates all options and services with the goal of optimizing the patient’s health status and outcomes and it integrates evidence-based clinical guidelines and protocols in the development of individualized care plans, manages a caseload of patients and provides targeted interventions to optimize healthcare utilization and coordinates care across the continuum of care and helps patient/families follow their plan of care.

PRIMARY FUNCTIONS & DUTIES

  1. Identifies targeted high-risk populations within practice sites per ADT (admission, discharge & transfer) notifications, payer lists, and PCP referral.
  2. Assesses the health care, educational, and psychosocial needs of the patient/family over time, using standardized assessment tools.
  3. Collaborates with PCP, patient, and members of the health care team, including community resources to meet the needs of the patient for optimum health outcomes.
  4. Responsible for developing a comprehensive individualized plan of care with targeted interventions. Continually monitors patient/family response to plan of care and revises the care plan as indicated.
  5. Provides self-management support with a focus on empowering the patient/family to build capacity for self-management.
  6. Coordinates patient care through ongoing collaboration with PCP, patient/family, facilities, community resources, and other members of the care team.
  7. Provides transitions of care follow-up with patient/family when patient transitions from one setting to another. Uses critical thinking skills to anticipate patients’ needs.
  8. Demonstrates excellent written, verbal, and motivational interviewing techniques. Builds positive relationships with the patient/family and care team.
  9. Completes required documentation for all care management services.
  10. Optimizes billing process for services rendered.
  11. Works with partnering practices for continuous process improvement.
  12. Completes required care manager trainings and annual payer educational requirements.

 EDUCATION, LICENSURE, AND CERTIFICATION

  1. Current RN Michigan license.
  2. BSN and previous care management experience preferred
  3. Minimum of two years of experience with patients in primary care/ambulatory care, home health, hospice and/or facility setting.
  4. Critical thinking skills and knowledge of patient self -management tools and techniques.
  5. Assessment skills and ability to implement evidence based interventions and protocols for chronic conditions.

JOB REQUIREMENTS

  1. Excellent verbal and written communications.
  2. Time management, priority setting, work delegation and work organization.
  3. General computer knowledge and electronic medical record experience.
  4. interpersonal skills to interact in an effective manner with providers, the health care team, community agencies, patients, and families with diverse opinions, values, religious and cultural beliefs.
  5. Ability to work autonomously and be directly accountable for patient panel.
  6. Ability to function effectively in a fluid, dynamic, and rapidly changing environment.
  7. Ability to develop positive, longitudinal relationships and sets appropriate boundaries with patients and families.
  8. Compliance with state and federal regulations, organizational policy, and accreditation.
  9. Local travel, the majority within work day

 Answer Health is committed to providing reasonable accommodations to qualified individuals with disabilities to allow them to perform the essential functions of their position.