Care Manager

ESSENTIAL FUNCTIONS 

• Assists with overseeing the daily inbound calls/tasks and emails for the department. 

• Ensures patient is progressing toward desired outcomes by continuously monitoring patient care through assessment and evaluation. 

• Identifies and resolves barriers that hinder effective patient care. 

• Improves quality and completeness of documentation. 

• Collaborates with patients, families, nurses, physicians, and other members of the team, building consensus around issues and appropriately resolves in a timely manner. 

• Documents in a clear, complete, concise, and organized manner. 

• Monitors clinically high risk and complicated cases and institutes necessary actions to promote quality care and appropriate integration. 

• Accepts referrals and identifies patients who meet the criteria for care management. 

• Analyzes current operations, policies, systems, procedures, and develops and implements necessary and innovative changes. 

• Adheres to and supports team members in exhibiting HOPCo’s values and mission. 

• Assists with program planning, development, and evaluation. 

• Performs related duties as assigned 

• Performs other CIN duties as assigned 

 EDUCATION 

• Bachelors or Doctorate in Nursing or Masters in Physician Assistant studies required  

EXPERIENCE 

• Minimum three (3) years of clinical nursing, therapy, or case management experience is required. 

• One-year experience in a medical business office, physician’s office, or hospital environment is preferred. 

• Experience in value-based care / population health is preferred. 

• Experience in orthopedic or musculoskeletal specialty is required.  

KNOWLEDGE  

• Knowledge of patient confidentiality, state laws, HIPAA regulations, and medical records procedures. 

• Knowledge of medical practices, terminology, and reimbursement policies. 

• Knowledge of Microsoft Office applications. 

SKILLS 

• Skill in follow-up with patients and responding to inquiries promptly. 

• Skill and professionalism when interacting with providers, patients, family members, and the public. 

• Skill in understanding patient education needs by effectively sharing information with patients and families. 

• Skill in problem-solving and time management. 

• Skill in evaluating the effectiveness of existing methods and procedures. 

• Skill in verbal and written communication. 

ABILITIES 

• Ability to read, interprets, and applies policies and procedures. 

• Ability to set priorities among multiple requests. 

• Ability to interact with patients, medical and administrative staff, and the nurse case manager effectively. 

• Ability to work in a fast-paced environment. 

ENVIRONMENTAL WORKING CONDITIONS 

• The position provides an option to work from home. If working from home, must have a designated workspace. 

• Use of standard office equipment, including computers, copiers, printers, etc. 

PHYSICAL/MENTAL DEMANDS 

• Requires sitting and standing associated with a normal office environment. 

• Some bending and stretching are required. 

• Manual dexterity using a calculator and computer keyboard. 

ORGANIZATIONAL REQUIREMENTS 

• HOPCo Mission, Vision and Values must be acknowledged and adhered to 

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.