Nurse Care Manager (Bilingual)

JOB SUMMARY:

Swope Health is seeking a bilingual Nurse Care Manager for the Quality Department.  Successful candidate will be an active member of the care team and will manage a full array of physical health needs, behavioral health needs, long-term community care services, and family services for the patients enrolled in our Accountable Care Organization. The RN Case Manager will provide support to primary care providers, community support staff (CSS's), case managers, care coordinators, and care navigators.

PRIMARY FUNCTIONS:

  • Assists patient through the healthcare system:

    • Acting as a patient advocate and navigator

    • Coordinating

    • Maintain communication between Primary care and Behavioral care teams and other outside providers involved with patient care

    • Encourage improved patient self-management ability by facilitating individualized patient education referrals and a

    • Coordinates continuity of patient care with providers, patients and families following hospital admission, discharge, and ER visits.

    • Facilitates and monitors patient medication management, education and adherence and provides intervention when needed to help improve understanding and adherence

  • Tracks quality and performance measures for all patients enrolled into our ACO

    • Identifies gaps in care and works to correct such gaps through care coordination, protocols and standing orders.

    • Identifies barriers to closing care gaps and collaborates with other medical staff, providers, and resources to attempt to resolve barriers

    • Participates on a team for data collection, health outcomes reporting, clinical audits.

  • Monitors patient care utilization

    • Assessing the appropriateness of services rendered

    • Attempt to reduce unnecessary costly expenditures (ER, hospital, and high cost testing) through the above activities

  • Make contact with new and established Medicare ACO patients to answer questions and provide information about the clinics and services.

  • Promotes effective working relations as part of a team to facilitate the team's ability to meet its goals and objectives.

    SECONDARY FUNCTIONS:           

  • Acts as primary contact point for Care Coordinators on the population health team regarding clinical questions and clarification

  • Attends all required training and continuing education as required or provided.

  • Other duties and/or responsibilities as assigned by manager or director

QUALIFICATIONS:       

  • Current, unrestricted license as Registered Nurse in State of Missouri (RN) and Kansas, BSN preferred.  Must have Missouri RN license to start, willing to hire RN without Kansas license if eligible to obtain Kansas license within the first 90 days of employment.

  • 2-5 years of experience in an outpatient clinical setting or previous experience in care coordination role

  • Basic Cardiovascular Life Support (BLS) certified

  • Proficient computer skills, including Microsoft Office (specifically Word, Excel, Outlook)

  • Experience with electronic medical records, eClinicalWorks preferred

  • Fluent in Spanish and English