Nurse Case Manager

• Base Pay $45.00 - $57.00 / Hour
• Job Category Nursing
• Employee Type FT Non-Exempt
• Required Degree 4 Year Degree
• Manage Others No

Qualifications

• Current CA RN licensure is required.
• Current BLS Healthcare Provider certification for infant, child and adult required.
• 2+ years work experience as RN is required
• 2+ years of case management experience preferred.
• Experience documenting in EHR systems preferred.

Work Experience

• Experience in an ambulatory or community clinic setting.
• Experience working with high-risk, complex patients including substance use, mental health, HIV and other co-occurring chronic conditions that may also have socio-economic risk factors.

Education

Graduate of an accredited school for RN is required.

Skills

Speaking, Active Listening, Reading Comprehension, Time Management, Writing, Critical Thinking, Judgement/Decision Making, Complex Problem Solving

Examples of Duties

This role involves providing clinical oversight to ECM cases. This includes troubleshooting issues and offering guidance and educational support to case managers. They will be responsible for assisting the ECM Clinical consultant in auditing ECM Comprehensive Assessments and Care Plans to ensure they are compliant with medical best practices and meet Managed Care Plan (MCP) requirements. This includes reviewing the care plans for completeness, addressing any gaps or barriers, and collaborating with case managers to finalize care plans before sign-off.

You will work closely with care team members crossing primary and specialty care, behavioral health, substance use services and care coordination/community health in supporting optimal outcomes across the continuum of care.

• With MD/DO oversight, and in consultation with the interdisciplinary care team, ensure safe and effective coordination of care within and between settings of care.
• Supports the medical care of patients under the direction of the medical staff pursuant to the objectives of the organization and in compliance with the Nurse Practice Act in the State of California.
• Provide competent, affirming and empathetic care that promotes preventive and chronic disease care, sexual health, mental health, and prevents substance misuse, to patients from diverse ethnic, linguistic, social and economic backgrounds,
• Monitor patient conditions and implement interventions in the care plan, reporting changes to the medical team.
• Coordinate and review cases, including the status of referrals, labs, tests, appointments and other key services.
• Collect and record patient data.
• Administer medications, injections and vaccines.
• Document current medications, compare against current orders and resolve discrepancies with the medical team.
• Conduct basic lab tests; communicate test results as indicated by the MD/DO.
• Monitor registries for patients due for care or whose vitals, labs or other tests are out of range, and outreach to patients to connect them to care.
• Develops resources and materials to promote education and training of staff and patients.
• Provide education to assist with self-management goals and disease management goals.
• Manage assigned caseload in an efficient and effective manner using time management skills.
• Develops clinical workflows, policies and procedures.

Additional Responsibilities

• Ability to adapt to change based on the needs of the patient, provider(s) and organization.
• Participate in grant and performance improvement projects and processes.
• Other duties as assigned.

Travel Requirements

Occasionally may travel to other sites to attend meetings or training; occasionally overnight for training.

Tools & Technology

Tools

Intravenous needles, bags and tubing; nebulizers or accessories; spirometers or its accessories; oxygen equipment or accessories, autoclave, glucometer, UA machine, sphygmomanometers, calculators or accessories, photocopiers, scanners, faxing equipment, computers and keyboards, telephones, EMR and other HIT systems.

Technology

Patient charting and scheduling software (NextGen); Microsoft Office programs including Word, Excel, Outlook, PowerPoint and Visio; population health analytic software.

Knowledge

Medicine, customer and personal services, English language, mathematics, education and training, patient safety and security, infection control, HIPAA, MSDS, medical terminology, personal protective equipment.

Abilities

Oral comprehension, oral expression, written comprehension, written expression, problem sensitivity, deductive reasoning; inductive reasoning, multi-task and shift priorities, make sound independent decisions by applying policies and procedures and using available resources.

Work Activities

Communicating with supervisors, peers, or subordinates; getting information; interacting with computers; performing administrative activities; making decisions and solving problems; organizing, planning, and prioritizing work; communicating with people outside organization; establishing and maintaining interpersonal relationships; documenting/recording information.

Work Styles

Integrity; dependability; attention to detail; cooperation; independence; initiative; self-control; adaptability/flexibility; concern for others; stress tolerance.

Work Context

Physical Demands

The physical demands and work environment described here are representative of those that must be met by an employee to successfully perform the essential function of the job, with or without accommodation. Prospective employees must complete a pre-employment medical exam (Occupational Group IV) which will measure the ability to:

• See well enough to read fine print and view a computer screen; speak and hear well enough to understand, respond, and communicate clearly in person and on the telephone; independent body mobility sufficient to stand, sit, walk, lift or move, stoop, and bend to access the work environment and a standard office environment; manual dexterity and sufficient use of hands, arms and shoulders to repetitively operate a keyboard and to write; and the ability to sit or walk for prolonged periods of time.
• Occasionally may be required to lift/move or assist in lifting/moving up to 50lbs.
• Reasonable accommodation may be made for some of these physical demands for otherwise qualified individuals who require and request such accommodation.

Work Environment: Generally, a typical office environment.

Requirements

Qualifications

• Current CA RN licensure is required.
• Current BLS Healthcare Provider certification for infant, child and adult required.
• 2+ years work experience as RN is required
• 2+ years of case management experience preferred.
• Experience documenting in EHR systems preferred.

Work Experience

• Experience in an ambulatory or community clinic setting.
• Experience working with high-risk, complex patients including substance use, mental health, HIV and other co-occurring chronic conditions that may also have socio-economic risk factors.

Education

Graduate of an accredited school for RN is required.

Skills

Speaking, Active Listening, Reading Comprehension, Time Management, Writing, Critical Thinking, Judgement/Decision Making, Complex Problem Solving

Summary

This role involves providing clinical oversight to ECM cases. This includes troubleshooting issues and offering guidance and educational support to case managers. They will be responsible for assisting the ECM Clinical consultant in auditing ECM Comprehensive Assessments and Care Plans to ensure they are compliant with medical best practices and meet Managed Care Plan (MCP) requirements. This includes reviewing the care plans for completeness, addressing any gaps or barriers, and collaborating with case managers to finalize care plans before sign-off.

You will work closely with care team members crossing primary and specialty care, behavioral health, substance use services and care coordination/community health in supporting optimal outcomes across the continuum of care.