What are the responsibilities and job description for the Care Manager position at Mosaic ?
Details Care Manager Inpatient Care Management Full Time Status Day Shift Pay Range: $30.48 - $48.77 / hour Summary
This position provides coordination of care for patients in Mosaic Life Care and the organization’s service area in such a manner as to use the right resources, at the right time and at the right level of care. Utilizing a collaborative process, the position will assess, plan, implement and evaluate the options and services required to meet an individual’s health and health related needs. Strong communication skills are necessary to access available resources and communicate with providers and other members of the interdisciplinary team. This position serves as an advocate for the patient, family and the organization to promote quality, cost effective outcomes. Active participation in program development and process improvement efforts is an expectation of this role. This position works under the supervision of the Director-Care Management and is employed by Mosaic Health System.
Duties Proactively identifies patients/individuals appropriate for CM service based upon indicators of each program (i.e. Utilization data, Quality data, Clinical indicators, etc) utilizing electronic tools, reports, and interview techniques effectively/efficiently to gather information about assigned populations and prioritizes workload appropriately to meet desired outcomes. Collects and reviews information to determine strengths and barriers of the patient in 6 key areas: access to care, current problems/treatment plans (medical/mental health), psychosocial/support system (formal and informal resources), functional status/safety, financial/benefits available, lifestyle/behavior (risk factors). Develops a plan to address identified barriers to care collaboratively with the patient/family, provider and interdisciplinary team. Prioritizes the plan appropriately to achieve optimal outcomes (Quality, Cost, Experience) avoiding a focus on task accomplishment. Coordinates/facilitates implementation of plan demonstrating problem solving skills, effective communication and appropriate sense of urgency in providing service to avoid delays in progression of care, and over, under, or inappropriate utilization of resources (include but not limited to unnecessary ED/IP visits, greater than expected LOS, unplanned readmissions, unnecessary testing/treatment, etc.). Develops and maintains knowledge of Medicare, Medicaid and key payer benefits/reimbursement methodologies necessary to procure services for patients and serve as a resource to the IDT on quality, cost effective care. Qualifications Graduate from school of nursing us required. BSN preferred. RN - Registered Nurse - State Licensure And/Or Compact State Licensure in the State of Missouri and Kansas (as needed for job assignment). BLS certification required within 90 days of start date. If operating a motor vehicle for business purposes, a valid driver’s license and insurance is required. Three years clinical experience, Care Management desired. Behavioral health care manager requires three years clinical experience in a Behavioral Health related field, Pregnancy Care Manager requires three years clinical experience in clinical field (obstetrical nursing). Experience navigating resources and computer systems to access information.
Salary : $30 - $49
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