Care Manager at Southeast Community Health Systems

Job DescriptionJob DescriptionDescription:Job Summary: Responsible for direction of patient care in the ambulatory care setting. Manages site nursing staff of SCHS. Consults with staff, physicians and Director of Nursing on nursing problems and interpretation of SCHS policies to ensure patient needs are met. Maintains performance improvement activities within the department and participates in CQI activities. Oversees care team and the coordination of patient care at the appointed site. Responsibilities include the management of high risk populations as determined by the Medical Director. The care manger is responsible for the identification of hospital admissions, hospital re-admissions, Emergency Room visits and ensuring proper follow up of the patient of Southeast Community Health Systems.DUTIES AND RESPONSIBILITIES:Coordinates and directs patient care to ensure patients’ needs are met and SCHS policy is followed.Communicates with local hospitals, clinics, specialist and insurance plans to ensure proper follow up after a hospital admission or Emergency Department visit.Decisions made reflect knowledge of facts, knowledge of diseases/surgical conditions, care required and good judgment.Ability to perform a head-to-toe preoperative assessment on all patients and reassess, as needed postoperatively. This includes infant to geriatric and the general patient population.Ability to adequately assess and reassess chronic disease. Utilizes appropriate disease management techniques. Educates the patient and family regarding disease process.Knowledge of medications and their correct dosing and administration, based on age of the patient and their clinical condition.Follows the five (5) medication rights and reduces the potential for medication errors.Performance reflects knowledge in all areas of care specific to SCHS.Ability to formulate an individualized plan of care, as indicated, and evaluate for effectiveness.Formulates a teaching plan, based on identified patient learning needs, and evaluates effectiveness of learning. Family is included in teaching, as appropriate. .Communicates routinely to assure compliance with visits and medications as appropriate to diseaseAbility to perform waived testing (point-of-care testing), interpret results and take appropriate action as required.Demonstrates an ability to assist providers and team members with procedures.Organizes and manages nursing activities at his or her site, reflecting due consideration for patients’ needs and the needs of facility and staff. Flexibility is maintained.Leads team members and coordinates member activities to assure continuity and monitoring of patient care on PCMH model.Treats patients and their families with respect and dignity; identifies and addresses psychosocial needs of patients and family. Practices good guest relations.Provides direct patient care, evaluates outcomes, consults with other specialists as required and adjusts nursing care processes as indicated to ensure optimal patient care.Other duties as assigned within scope of licenseRequirements:Regulatory Requirements:Graduate of an accredited school of nursing with care management/ambulatory care experience preferred.Current LPN or RN license within the state of practice.Current BLS certificationLanguage Skills:Able to communicate effectively in English, both verbally and in writing.Skills:Basic computer knowledge.