Rn - care Manager/chronic Disease Care/change Management

Nurse Care Manager

It's more than a career, it's a calling.

WI-SSM Health Erdman

We are looking for an experienced nurse care manager with strong Change Management skills as well as strong assessment skills related to chronic disease.

Nurses in this department call patients who have either recently been in the hospital or have at least two chronic diseases. They use motivational interviewing skills to determine healthcare-related goals their patients want to work on to improve their health and keep them from hospital stays/emergency department, etc.

This Care Manager position is Monday - Friday days with a hybrid schedule. Meaning some in person and some remote work.

Job Summary:

Utilizes skilled intervention, clinical best practice knowledge and collaboration with the patient, physician and multidisciplinary treatment team to pace care, achieve quality outcomes and negotiate appropriate reimbursement. Ensures the timely and seamless clinical transition of patients through medically appropriate levels of care.

Job Responsibilities and Requirements:

Primary Responsibilities:

• Reviews all patients identified for review to determine the medical necessity and appropriateness of enrollment in the care management program.
• Assesses all assigned patients and integrates family information from social work to collaboratively determine potential, actual and the next level of care needed.
• Holds, interprets, and integrates the patient's story into the overall multidisciplinary plan of care.
• Coordinates and facilitates access to services and patient care progression using best practice interventions that will produce favorable patient outcomes.
• Collaborates with physicians, nursing, social work, and multiple disciplines, departments, payers, and agencies to eliminate barriers to efficient delivery of care in the appropriate setting.
• Actively participates in clinical performance improvement activities as assigned.
• Builds a network of positive working relationships that advocate for the patient.
• Documents clinical activity in the medical record and supports and coaches accurate clinical documentation by physicians and others.
• Pursues continuing education in area of expertise/leadership.
• Works in a constant state of alertness and safe manner.
• Performs other duties as assigned.

Education:

• Graduate of accredited school of nursing or education equivalency for licensing

Experience:

• Two years' registered nurse experience

Physical Requirements:

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
• Frequent keyboard use/data entry.
• Occasional bending, stooping, kneeling, squatting, twisting and gripping.
• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
• Rare climbing.

Required Professional License and/or Certifications:

• State of Work Location: Illinois
• Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR)
• State of Work Location: Missouri
• Registered Nurse (RN) Issued by Compact State
• Or
• Registered Nurse (RN) - Missouri Division of Professional Registration
• State of Work Location: Oklahoma
• Registered Nurse (RN) Issued by Compact State
• Or
• Registered Nurse (RN) - Oklahoma Board of Nursing (OBN)
• State of Work Location: Wisconsin
• Registered Nurse (RN) Issued by Compact State
• Or
• Registered Nurse (RN) - Wisconsin Department of Safety and Professional Services

Work Shift: Day Shift (United States of America)

Job Type: Employee

Department: 8149000069 Value Based Care

Scheduled Weekly Hours: 40

Benefits:

SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.

• Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
• Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
• Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members.

SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law.