The Lead RN Care Manager Community Care is responsible as a Registered Nurse with years of diverse nursing experience and success in managing complex situations. The Lead RN Care Management Community Care acts as an advocate for their team making sure the Clinical Manager/Director are aware of the unique needs of the team. The Lead RN Care Manager providers leadership for personnel by being a team leader serving as a preceptor and being an active member of the health care team. The Lead RN Care Manager is an expert in clinical nursing knowledge for specific populations and chronic diseases. This position requires both internal and external interface with providing care management to populations the connect with health insurance attributed lists emergency rooms hospitals primary care services. The Lead RN care manager functions across the care continuum interfacing with the multi-disciplinary team to facilitate the best possible clinical outcomes and optimal level of wellness with the most appropriate resource. This role is essential to the success of meeting high risk patients needs post- discharge and preventing unnecessary readmissions. The Lead care manager will collaborate with the interdisciplinary team to identify assess plan implement coordinate monitor and evaluate options and services in meeting the needs of high risk individuals and their complex medical needs.
Responsibilities
Personnel Leadership
* Oversees the design and follow through of an orientation that addresses the individual needs of the employee.
* Assist in adjustment of daily assignments based on staffing and acuity of caseload.
* Establishes and maintains mutual trust and respect with staff.
* Promotes an environment that motivates nurtures and empowers staff. Supports department communication lines through the use of huddles department meetings and other means of fostering employee engagement.
* Works with employees to facilitate and achieve skill educational and performance goals.
* Completes timely evaluations of staff and collaborates with manager/director on corrective action plans for team members.
* Addresses workflow issues ensures incidents are appropriately documented and corrective steps are taken.
* Embraces an improvement mindset and works with departmental leadership on identification and implementation of process improvement initiatives.
* Advocates for both patients and staff as needs arise.
* Demonstrated knowledge of NAH and department policies and procedures. Works with other departmental leadership to ensure compliance of best practice amongst each staff member.
Patient Care
* Evaluate attributed patients identified to provide clinical care management risk attribution.
* Complete psychosocial assessments and develop care plans with identified patient to lower risk threshold for care delivery.
Care Coordination
* Develop a relationship with primary care specialty services emergency and hospital networks required for inter-disciplinary care management.
* Facilitates the progression of care by advancing the care plan identification of outcomes implementation plan and sets goals that are measurable realistic and individualized.
* Utilizes hospital community and national resources to maintain and enhance knowledge and expertise of the care management team.
* Identifies highest quality most effective post discharge providers and builds relationship to provide highest quality lowest cost care at the right stage of patients recovery.
Utilization Management
* Ability to utilize care delivery techniques such as teach back and motivational interviewing to support patient success.
* Supports patient to ensure appropriate compliance and support occurs to avoid readmission or poor quality outcomes.
* Monitors outcomes and develops process change to improve care.
Data Applications
* Respects and upholds patient rights demonstrates professional integrity maintains patient confidentiality discloses all potential or perceived conflicts of interest when appropriate; accepts responsibility and accountability for professional competence.
* Ensures appropriate documentation in the electronic medical record.
Compliance/Safety
* Stays current and complies with state and federal regulations/statutes and company policies that impact the employees area of responsibility.
* If required for position ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates.
* Completes all company mandatory modules and required job specific training in the specified time frame.
* Responsible for reporting any safety related incident in a timely fashion through the Midas/RDE tool; attends all safety related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.
Qualifications
Education
Bachelors Degree in Nursing- Required if hired after December 2018 Masters Degree in Nursing- Preferred
Certification & Licensures
Current unrestricted license in the State of Arizona- Required
BLS (American Heart Assoc.)- Required Fingerprint Clearance Card application number- Required upon date of hire; and Fingerprint Clearance Card- Required within 90 days of date of hire
Experience
Two years as a Registered Nurse- Required Two years Care Management or Nurse Navigator experience- Preferred
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