Care Manager, Outpatient

North Memorial Minneapolis, MN
DescriptionCare Manager: As an integral member of the health care team, the care manager provides clinically based care coordination to support the delivery of quality customer care as efficiently as possible. The care manager has accountability for individual customers ensuring quality clinical outcomes and

appropriate resource management within an assigned caseload. With the customer, family, and health

care team, the care manager creates and organizes a care plan (or contributes to an existing care plan) appropriate to the customer's needs and resources and ensures that the customer is receiving the right care, at the right level across the continuum.

The care manager works with the primary care provider and clinic care coordinator as an integral part of the care management team to ensure that care for the most vulnerable or complex customers is coordinated and managed. Customers must receive optimal care including acute illness management, chronic disease management, and preventive care across multiple health settings and multiple physicians/providers. The care manager applies the process of assessment, planning, implementation, monitoring, evaluation and coordination of care to meet the customer's health care needs across the continuum.

The care manager must activate the customer and form meaningful relationships with customers/families. Must develop care plans that prevent disease exacerbation, improve outcomes and increase customer self engagement in care. Must demonstrate an understanding of customer-centered care. The care manager must also meet the compliance standards of specific health plans and other external agencies as appropriate.

Accountabilities:

Promotes customer-centered care based on jointly determined health care goals and priorities.

Ability to reach out to customers to ensure program understanding and enroll in appropriate customer programs supported by their clinic or payer.

Functions as a resource to customer care units, ambulatory clinics and medical staff regarding the payer products and panel the customer is aligned with.

Applies clinical judgment to determine level of care and resources needed.

Monitors, trends and records customer response to disease, illness, treatment.

Documents appropriately as required by public and payer systems.

Projects a positive image through professional behavior and building positive relationships with customers, families, providers, and other staff.

Accepts other duties as assigned to promote the accomplishment of organizational goals.

The team member is accountable to demonstrate proficiency for the skills outlined in the appropriate position skills list.

The team member is accountable to maintain skill proficiency, including improvement where deemed necessary, and upgrading any additional or new skills on the appropriate position skills list.RequirementsEducation

Graduate from an accredited school of nursing required; BSN or BAN preferred; or BSW from an

accredited school of social work.

Experience

Care coordination experience preferred.

Clinic experience preferred.

Knowledge, Skills and Abilities

Excellent verbal and written communication skills required.

Needs assessment skills.

Evaluation skills.

Knowledge of relevant policies and procedures.

Customer interaction and motivational skills.

Customer triage skills.

Project a positive image through professional behavior and building positive relationships with

customers, families, providers and other staff.

Demonstrated ability to collaborate with other disciplines both in and out of health care system.

Demonstrated ability to problem solve proactively using sound judgment based on factual

information and clinical knowledge.

Demonstrated ability to use behavioral strategies such as motivational interviewing.

Demonstrated understanding of concepts associated with utilization management.License Requirement Registered Nurse

State Requirement

OR

Licensed Social Worker

State RequirementAdditional InformationPrevious Experience with MSHO/MSC+ is preferred

At North Memorial Health, we're on a mission to change healthcare. We're delivering unmatched customer service and empowering our customers throughout Minnesota and Western Wisconsin to achieve their best health. North Memorial Health is a leader in delivering advanced medical care from Emergency, Urgent Care, Specialty Programs and Services, Primary Clinics, Ambulance and Air Medical Transportation.