Chronic Care Manager

Job purpose

The Chronic Care Management (CCM) Nurse provides non-face-to-face care management services for Medicare beneficiaries with multiple chronic conditions under the supervision of a billing practitioner. The CCM Nurse supports patient enrollment develops and maintains comprehensive care plans coordinates care across the healthcare continuum and ensures documentation supports Chronic Care Management billing requirements. Performs services consistent with Centers for Medicare & Medicaid Services (CMS) Chronic Care Management regulations ensuring that program activities meet all clinical documentation and compliance requirements necessary for Medicare reimbursement. Maintains designated Chronic Care Management service time to conduct patient outreach care coordination documentation and registry management required for CCM program compliance and billing. The nurse is not routinely assigned unrelated clinical duties except in urgent operational circumstances

Qualifications

Education and Licensure

• Licensed Practical Nurse (LPN) minimum required or Registered Nurse (RN) preferredwith current New York State licensure.

Preferred Experience

• Experience in care coordination chronic disease management or population health programs.
• Familiarity with Medicare Chronic Care Management services and CMS documentation requirements.
• Experience using Electronic Medical Record systems.

It is the employees responsibility to know the requirements for certification limited permits and licensures for their individual profession. It is also the responsibility of the employee to notify the employer of the status of any certification or licensure issue or potential issue. The employee will comply with all the requirements outlined by the New York State Office of Professionals for the profession.

Working conditions

• Work is performed in a clinical office environment and includes extended periods of computer use and telephone communication.
• Exposure to communicable diseases and other healthcare-related hazards may occur.

Physical requirements

• Position requires standing walking sitting bending and occasional lifting consistent with clinical office duties