Registered Nurse, Care Manager

Overview The Department of Family Medicine at Macon & Joan Brock Virginia Health Sciences at Old Dominion University is seeking an RN, Care Manager to join the team. Responsibilities Provide prescribed medical treatment and personal care services to ill, injured, convalescent and disabled persons in settings such as hospitals and/or a doctor’s office. Lead team members who provide care coordination services, including Medicare Wellness Visits, Care Management of Chronic Diseases, and Transitional Care Management. Assist with departmental ACO quality measures, resident education, and quality projects. Mentor other clinical staff such as Medical Assistants and LPNs; responsible for direct supervision and training of LPNs. Work with the Chief Quality Officer to improve clinical quality metrics and outcomes in the department and organize/provide leadership toward ensuring that the department meets ACO Quality Measures. Identify opportunities and provide recommendations for workflow optimization within the care management team. Supervise LPNs, including managing performance, approving timecards, and issuing corrective action when needed. Schedule and conduct Medicare Wellness visits in compliance with current CMS guidelines. Complete patient assessments over the phone during TOC calls following discharge from inpatient facilities and communicate any status changes or patient needs to the appropriate provider. Conduct chart audits of Medicare Wellness visit notes and TOC notes completed by LPNs to ensure all criteria for appropriate billing have been met. Communicate changes to CMS guidelines with care managers and billers. Assist with specialty clinics as needed. Coumadin Clinic – Check patient INR, adjust Coumadin dose as needed, review and teach diet restrictions, document results, and bill for procedures. Coordinate with home health nurses regarding INR results and dose adjustments. Colposcopy Clinic – Set up and assist with procedures. Assist physicians with Colposcopy procedures. Process and send specimens to pathology. Record in the Procedures notebook, follow up for results, physician’s verification, and patient notification. Call no-show patients and reschedule. Minor surgery clinic – Set up clinic and assist with procedures. Process and send specimens. (Dermatology, Labcorp) – Follow results for physician verification and patient notification. Flexible Sigmoidoscopy – Performed during minor surgery; assist physician. Call patients prior to and after appointment to review prep and answer questions. Treadmill Clinic – Prepare patients for testing, assist with the test, monitor vital signs, and call patients prior to testing to verify appointment, review instructions, and answer questions. Complete all in-basket requests assigned to the individual team, including responding to patient messages, prescription refills, lab results, referrals, home health agencies, medication prior authorizations, patient forms, and follow-up from physicians. Ensure all tasks are reviewed and marked complete by the close of each business day. Respond to questions from patients, family members, faculty/residents, and other health care providers in a timely and professional manner. Document all patient conversations in the electronic medical record. Take and record patients’ vital signs. Administer specified medications, orally or by subcutaneous or intramuscular injection, and note time and amount on patients’ charts. Assemble and use equipment such as catheters, tracheotomy tubes, and oxygen supplies. Collect samples (urine, blood, sputum) for testing and perform routine laboratory tests on samples. Minimum Qualifications and Skills RN diploma. Must be a licensed RN in Virginia. Completion of BLS class with recertification every two years. Ability to make professional nursing decisions up to the scope of practice for licensure and possess the knowledge and critical thinking skills to support those decisions. Possess complex patient management skills. Possess assessment and medical decision-making skills and develop a care plan for wellness visits. Possess professional interaction skills with physicians, patients, outside offices, pharmacies, referring agencies, hospital personnel, and support staff. Ability to lead and manage teams. Ability to coordinate and track Clinical QI Projects. Ability to work with senior leadership. Location: US-VA-Norfolk #J-18808-Ljbffr