Ambulatory Care Manager - RN - Georgia Heart Institute GHI

Job Category

Nursing - Registered Nurse

8 Hr Morning - Afternoon

Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.

The RN Care Manager will assist NGPG Providers in applying systems, science, incentives, and information to improve medical practice and patient care, eliminate duplication, and reduce the need for medical services by helping patients and their support systems in managing medical conditions more effectively. The RN Care Manager will: independently, and in collaboration with providers, identify populations with modifiable risks; align care manager services to the needs of those patients, and implement interprofessional team‑based approaches to care.

The RN Care Manager will provide those services determined to assist patients in achieving an optimal level of wellness and improve coordination of care while providing cost effective, non‑duplicative services. The primary responsibility of the RN Care Manager is to assist in the identification and management of NGPG patients with complex health care needs. Care management services may be provided in a variety of settings including in‑person, face‑to‑face encounters, by telephone, or electronic encounters such as telehealth visits.

Primary areas of focus will include management of patients with multiple chronic conditions, including those complex health care needs identified by NGPG providers and managing transitions of care. Clinical care such as medication reconciliation, assessment of adherence to treatment plans, and the identification of adverse events can facilitate intensified treatment and/or mobilize additional patient support.

• Licensure or other certifications: Current Georgia RN license required. Current BLS certification required or must be obtained within 30 days of hire.

• Educational Requirements: Associates Degree.

• Minimum Experience: A minimum of three (3) years experience as a licensed registered nurse.

• Other:

• Preferred Licensure or other certifications:

• Preferred
  
  Educational Requirements:
  
  Bachelors and/or Masters Degree.

• Preferred Experience: A minimum of one (1) year experience providing care management within a primary care setting.

• Other:

• High energy and ability to function effectively in a dynamic work environment
• Strong organizational and interpersonal skills; able to work effectively in a team environment
• Excellent written and verbal communication skills
• Strong analytical and problem‑solving skills; ability to review reports and complete data validation
• Excellent understanding of medical terminology and disease states
• Able to interpret complex regulations
• Maintains current continuing education appropriate to care management
• Demonstrated expertise with Microsoft Excel and reporting databases

• Collaborates with providers in promoting the delivery of high quality medically appropriate care and services using fiscally responsible strategies.
• Uses the nursing process to assess, plan, implement, and evaluate patient care and the use of resources.
• Assists in the development, implementation, and analysis of a process for providing outreach to patients with identified care opportunities including, but not limited to, non‑compliance, and maintaining clinical markers (e.g., blood pressure, HbA1c) within normal range.
• Monitors the quality of care to ensure all aspects of services are safe and appropriate.
• Assists in the continuous identification, stratification, and prioritization of patients at highest risk who offer the greatest potential for improvements in health outcomes. Use the EMR and other methods to facilitate care coordination and effective communication with patients and outreach to them.
• Incorporates clinical and non‑clinical sources of information in identifying those patients who will most benefit from care management services. Use timely, all‑inclusive team communication and collaboration on patient assessments, care planning, and interventions. Effectively uses the following tools/strategies…