Care Manager RN

Alcona Health Center (AHC) is a non-profit FQHC serving rural Northern Michigan with medical, dental, and behavioral health care. We also provide recovery programs and pharmacy services to expand access to care in underserved communities. Join our team and deliver patient-centered care through the Patient-Centered Medical Home model. Explore open roles in clinical care, finance, IT, and more. Each position supports healthier lives across Northern Michigan. Care Manager RN Job ID: A26-108 Location: Alpena About Our Family Established in 1978, Alcona Health Center (AHC) is a non-profit, Federally Qualified Health Center dedicated to making a lasting impact in the Northern MI communities we serve, offering medical, behavioral health, dental and pharmacy services. As a member of the AHC family, you will join a team of over 300 coworkers, all devoted to providing quality health care to all residents of our communities, regardless of their ability to pay. Your Valued Contributions The Care Manager is a practice-based RN who directly supports AHC’s highest risk patients. In collaboration with other members of the healthcare team, the Care Manager is responsible for organizing, coordinating, and providing care coordination and care management services to patients within the practice who are most at risk for health deterioration, sentinel events, and/or poor outcomes. The Care Manager role directly supports organizational initiatives surrounding health outcomes for identified patients based on condition, risk status, and other initiative focuses. As a Care Manager: Patient Care Activities Conduct comprehensive assessment of patients’ physical, mental, and psychosocial needs Develop care plans to prevent disease exacerbation, improve outcomes, increase patient engagement in self-care, decrease risk status, and minimize hospital and Emergency Room utilization. Utilize behavioral strategies help patients adopt healthy behaviors and improve self-care in chronic disease management. Promote self-management goals. Assist patients in navigating the health care system. Coordinate Specialty care, follow-up on test results and other care coordination needs. Partner with external case management programs to coordinate care. Ongoing evaluation and documentation of patient progress/ risk status. Patient-Center Medical Home Pro-actively support Patient Centered Medical Home (PCMH) initiatives related to care coordination Pro-active member of care teams in team-based care initiatives Partner with PCMH staff to develop integrated care management programs Annual Wellness Visits Conduct annual wellness visits as defined by Medicare with patients in coordination with site provider based on site need and patient volume, if applicable. Communication and Health Information Entered into Patient Record Enters appropriate treatment information into patient record in a timely fashion. Progress notes documentation is completed accurately, is written and maintained in a manner that is clear, complete, current, and organized in accordance with state and federal regulatory requirements. Progress notes entered into electronic record to insure appropriate ongoing patient care. Continuously review charts for new and/or relevant information concerning clients. Communicates patient’s health status to provider to insure adequate provision of care. Evaluates complexity of patient's condition and determines appropriate level of care management, referring to an LPN care manager if available and appropriate. Routinely speaks at site, MSS, and provider meetings to remind staff of the services offered through Care Management and to encourage referrals from all staff. Required Training & Experience Use of Electronic Health Records Word & Outlook Possesses a current Basic Cardiac Life Support CPR certification. Possesses a current State of Michigan driver’s license and valid automobile insurance. Possesses a current Michigan state licensure to practice nursing (RN). We’re Here For You Supporting Balance: As a part of our family, you will work full time with a negotiable starting wage, dependent on education and experience, with predicable scheduling, numerous holidays, generous vacation time and sick days. Supporting Your Health: Low deductible Medical, Rx, Vision & Dental insurance at a minimal cost for employees. Supporting Your Future: Retirement Savings Plan, FSA, Life, AD&D, & Short/Long Term Disability Insurance. Supporting Your Education: Continuing Education Assistance program. Employment with AHC may also qualify you for student loan forgiveness under the Public Service Loan Forgiveness program. Fighting Against Discrimination Alcona Health Center is an Equal Opportunity Employer and Prohibits Discrimination and Harassment of Any Kind: Alcona Health Center is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment. All employment decisions at Alcona Health Center are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy, sexual orientation, and transgender status), age, physical, mental or sensory disability, HIV Status, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. Alcona Health Center will not tolerate discrimination or harassment based on any of these characteristics. Alcona Health Center encourages applicants of all ages. Upon request auxiliary aids and services will be made available to individuals with disabilities. Michigan Relay Center “Voice and TTY/TDD” View phone number on click.appcast.io. An EOE. #J-18808-Ljbffr