RN High Risk Care Manager - Charleston

Job Description Summary

The Nurse Care Manager (Population Health) reports to the Director of Value Based Care Coordination. Under general supervision, the Nurse Care Manager (Population Health) functions as a member of population health, primary care outpatient focused teams.

This role coordinates a patient-centered, evidence-based plan of care to achieve optimal clinical outcomes for targeted high-risk populations; coordinating efforts with acute care and ambulatory providers and care team members, and community partners.

This position promotes medical home concepts and a patient/family-centered team approach to care. The Nurse Care Manager (Population Heath) serves as a clinical expert and resource related to care transitions and outpatient care management.

Entity

Medical University Hospital Authority (MUHA)

Worker Type

Employee

Worker Sub-Type​

Regular

Cost Center

CC002347 SYS - Population Health Program

Pay Rate Type

Salary

Pay Grade

Health-28

Scheduled Weekly Hours

40

Work Shift

Job Description

The RN High Risk Care Manager reports to the Manager of Population Health Care Coordination. Under general supervision, the Care Manager functions as a member of the Population Health and Primary Care Medical Home (PCMH) teams to provide care coordination and management services to targeted high-risk populations. 

The RN Care Manager works collaboratively with the patient and caregiver(s), the Population Health team, PCMH team, other specialty providers and case management/care coordination teams, and community agencies to develop and implement a coordinated plan of care to achieve optimal clinical outcomes and value-based program goals. The RN Care Manager provides education and support to patients enrolled in the program, spending time with patients that is not achievable in a traditional office appointment. Utilizing the RN care management process, this position promotes medical home concepts and a patient-centered, team approach to care.

This role functions in an embedded model, with the RN Care Manager working mainly within MUSC Primary Care clinics in the Charleston area, with an option to work remotely one day per week as determined by program and patient needs. The RN High Risk Care Manager serves as a clinical expert and resource related to outpatient care management.

Section 3: Job Responsibilities:

Completes a comprehensive care management assessment utilizing motivational interviewing techniques in conjunction with the patient/caregiver, the primary care provider and the PCMH team. Develops, implements, and evaluates a patient-centered plan of care for each patient enrolled in the High-Risk Care Management program. Collaborates and communicates with providers, team members, and community agencies to ensure care is effective, safe, efficient, equitable and timely.

Provides education tailored to the individual patient’s learning needs and preferences. Assists patients and caregivers with self-management strategies and provides encouragement, support and resources as needed to facilitate progress towards health-related goals. Supports and helps resolve psycho-social needs reassesses the patient’s progress toward goals, and revises the plan of care as needed. Coordinates care and maintains contact with the patient’s larger care team as appropriate. Supports data collection and outcomes reporting for the High-Risk Care Management program to ensure progress towards value-based program goals.

Education:

Bachelor’s degree in Nursing required.  

Four (4) or more years of related work experience as a registered nurse required.

Case or Care Management experience and/or certification in Case or Care Management preferred.

Current South Carolina licensure or licensure in a compact state as a registered nurse required.

Current Basic Life Support (BLS) required, either a certification from an American Heart Association (AHA) BLS for Healthcare Providers (or AHA recognized equivalent) or an American Red Cross CPR/AED for Professional Rescuer and Healthcare Provider.

Work Requirements:

• Requires excellent oral and written communication skills, strong organizational and time management skills.
• Ability to establish cooperative relationships and must be sensitive to the needs, concerns and safety of patients and visitors/families of diverse cultural orientation.

Physical Requirements:

• Ability to perform job functions while standing. (Frequent)
• Ability to perform job functions while sitting. (Frequent)
• Ability to perform job functions while walking. (Frequent)
• Ability to climb stairs. (Infrequent)
• Ability to work indoors. (Continuous)
• Ability to work in confined/cramped spaces. (Infrequent)
• Ability to perform job functions from kneeling positions. (Infrequent)
• Ability to bend at the waist. (Infrequent)
• Ability to squat and perform job functions. (Infrequent)
• Ability to perform 'pinching' operations. (Infrequent)
• Ability to fully use both hands/arms. (Continuous)
• Ability to perform repetitive motions with hands/wrists/elbows and shoulders. (Continuous)
• Ability to reach in all directions. (Frequent)
• Possess good finger dexterity. (Continuous)
• Ability to lift and carry 15 lbs. unassisted. (Infrequent)
• Ability to lift/lower objects 15 lbs. from/to floor from/to 36 inches unassisted. (Infrequent)
• Ability to lift from 36 inches to overhead 15 lbs. (Infrequent)
• Ability to maintain 20/40 vision, corrected, in one eye or with both eyes. (Continuous)
• Ability to see and recognize objects close at hand. (Continuous)
• Ability to match or discriminate between colors. (Continuous)
• Ability to determine distance/relationship between objects; depth perception. (Continuous)
• Good peripheral vision capabilities. (Continuous)
• Ability to maintain hearing acuity, with correction. (Continuous)
• Ability to perform gross motor functions with frequent fine motor movements. (Continuous)
• Ability to work in a latex safe environment. (Continuous)
• Ability to deal effectively with stressful situations. (Frequent)

Additional Job Description

Bachelor of Nursing degree preferred with minimum of one year of experience. RN staff hired on or after July 1, 2013 with an Associate or Diploma degree in nursing are required to be enrolled in an accredited BSN program within two years and successfully obtain a BSN degree within four years of the RN hire or reclassification date. Refer to policy A141 for more details. Prior leadership experience preferred. One year of case management and/or utilization review work experience preferred. Case Management certification preferred. Licensure as a registered nurse by the state of South Carolina or compact state required. Certification in Case Management preferred. Current American Heart Association (AHA) Basic Life Support (BLS) certification or American Red Cross BLS for Healthcare Providers certification is required

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

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