Nurse Case Manager
Position Overview: The Nurse Care Manager is responsible for complete case management of all patient needs. Interviews patients and families to assess needs and risk categories to develop and implement appropriate plans of care. Assures quality clinical care by coordinating all services and collaborating with doctors on plan of care. Implements, monitors and evaluates the plan of care and its effectiveness on a regular basis. Communicates regularly with relevant staff members and family members on patient’s progress.
- Participates in the initial nursing assessments, infectious disease screenings and laboratory results, and developments of the service plan accordingly.
- Assist in the implementation of policies and protocols in regard to routine screening of infectious diseases.
- Implements services to patients in accordance with their individualized treatment plan.
- Collaborates with the patient and patient’s family or significant others to implement an effective service plan, explaining the available clinical options to the team, including the advantages and disadvantages of each option.
- Maintains communication with providers from a higher levels of care whom are currently providing more intense medical, psychiatric, or legal services to our patients.
- Maintains the patient’s comprehensive clinical record, including documentation of activities performed as part of the service delivery process (e.g., assessments, provision of services, coordination of care, follow-up, discharge planning).
- Works collaboratively with the clinical and medical team to engage, educate, communicate, and coordinate care with patient, their family, behavioral and general medical and dental health care providers, community resources and others to ensure that all services prescribed in the individualized treatment plan are implemented.
- Aids in maintaining, monitoring and modifying covered health services and referring when uninsured to gain coverage.
- Seeks out necessary resources other than covered services to meet basic needs.
- Coordinates prior authorizations for medications offered with in the facility
- Ensures all appropriate referrals for identified services on the service plan are made and coordinated with high quality service providers via contracted network providers or community resources including specialty services such as nephrology, cardiology, hepatology, endocrinology, etc.;
- Ensures all covered services identified on the service plan are evaluated and updated as per required timeframes.
- Ensure Prescription Drug Monitoring Program report is reviewed at admission to prevent adverse interactions and effects, develop strategies to eliminate and reduce polypharmacy, and intervening where needed to protect the health and well-being of the client.
- To support daily nursing activities such as dispensing daily medications, inventory reconciliation, assessments, and other duties as assigned.
- Bachelor’s degree in nursing or RN from qualified nursing school, OR
- Bachelor’s Degree in a social work field or equivalent combination of education, training, AND RN from qualified nursing school.
- Minimum of one (1) year in Behavioral Health or Psychiatric.
- Knowledge of health care, addiction, co-occurring disorders, DSM Criteria, and terminology.
- Ability to read and interpret written information; write clearly and informatively; edits work for spelling and grammar. Ability to speak clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions; demonstrates group presentation skills; and participates in meetings.
- Working knowledge of Microsoft Word, Excel, and Outlook.
- Job Knowledge: Understands duties and responsibilities, has necessary job knowledge, has necessary technical skills, understands company mission/values, keeps job knowledge current, is in command of critical issues.
- Communication: Excellent written and verbal communication skills. Creates accurate and punctual reports, delivers presentations, shares information and ideas with other.
- Problem Solving: Identifies problems involves others in seeking solutions, conducts appropriate analyses, searches for best solutions; responds quickly to new challenges
- Decision Making: Uses effective approaches for choosing a course of action or developing appropriate solutions and/or reaching conclusions; take action consistent with available facts, constraints, and anticipated consequences.
- Collaboration: Works collaboratively with other health professionals in the organization and leaders from other disciplines when appropriate.
Work Environment: This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets.
Travel: Travel is primarily local during the business day, although some out-of-the-area and overnight travel may be expected.