Care Manager Job
Full Job Title: Care Manager
Job Number: 17007432
Facility: SSM Health Medical Group
Location: St. Charles County, MO
Schedule: Full Time, Days
Hours: 8 am - 5 pm
- Works with Medical Group leadership in the design, implementation, and evaluation of the Medical Home care model.
- Identifies the targeted population within his/her practice site and risk stratifies all members to prioritize needs and direct interventions.
- Assesses the healthcare, educational and psychological needs of the member/family. Designs an individualized plan of care with the member and fosters a team approach by working collaboratively with the member, family, primary care provider, and other members of the health care team to ensure coordination of services.
- Implements clinical interventions based on risk stratification and evidence-based clinical guideline adherence and promote best practice by initiating/adjusting therapies as directed by the practitioner and providing appropriate follow-up and monitoring as needed. Coordinates appropriate laboratory and diagnostic testing.
- Coordinates referrals and other community resources.
- Implements systems of care that facilitate close monitoring of high-risk members to prevent and/or intervene early during acute exacerbations.
- Continuously evaluates laboratory results, diagnostic tests, utilization patterns and other metrics to monitor quality and efficiency results for assigned population.
- Works closely with the practice care team and serves as a resource to the member and healthcare team.
- Adheres to SSMHC Administrative standards regarding patient confidentiality.
- Maintains required documentation for all care management activities. Collects required data and utilizes this data to adjust the treatment plan when indicated.
- RN licensure or eligible for licensure in the state of Missouri required
- 3 to 5 years of experience in clinical nursing, case management and managing Medicare patients required.
- Critical thinking skills and the ability to analyze complex data sets required
- General computer knowledge and the capability to use a computer required
- Bachelor's degree in Health Care preferred
- Case Management Certification preferred
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