Care Manager

National University Polyclinics; Singapore; On-site; SGD 60,000 - 90,000; Full time

Job summary

National University Polyclinics is seeking a Care Coordinator to manage care coordination and ensure holistic patient care across Alexandra Hospital’s programs.

The role emphasizes case management, collaboration with clinicians and community partners, and contributing to quality improvement in patient care pathways within NUHS.

Qualifications

• Degree or equivalent professional qualification in Nursing, Social Work or Allied Health.
• Experience in hospital or community care settings is preferred.

Responsibilities

• Coordinate care across multidisciplinary teams to support patient care plans.
• Liaise with Clinical Directors, Programme Leads and service partners to ensure seamless transitions.
• Advocate for patient and caregiver needs and manage care transitions in the hospital and community.

Skills

Healthcare teamwork

Patient advocacy

Communication skills

Analytical thinking

MS Word

MS Excel

PowerPoint

Education

Bachelor's degree in Nursing / Social Work / Allied Health

Tools

MS Word

MS Excel

PowerPoint

Job description

The Care Coordinator (Care Manager) is responsible for managing operational requirements and upholding exceptional service standards within their designated service support area. In this role, they provide support to the Clinical Director(s), relevant Clinical Programme and Service Leads, serving as a key advocate and liaison to facilitate holistic patient care across Alexandra Hospital's seven specialized programs. Through effective stakeholder engagement both within and beyond the department, they support operational oversight and inter-program coordination to help drive better care delivery with a primary focus on case management and care coordination.

The incumbent may also support the department in collaborations with internal and external stakeholders, such as community service providers, government agencies, and multidisciplinary healthcare teams to constantly review and improve the coordination and continuity of patient care across the healthcare continuum relevant to his/her support area.

The incumbent contributes to a healthy environment that embodies the department’s philosophy – one that advocates for, supports, and provides holistic, individualized, and coordinated care to patients and their caregivers, to help them to cope better within their community and improve health outcomes and quality of life.

Job Responsibilities

You will be responsible for the following:

C3U-Clinical Programme Liaison for case management and care coordination

• Work closely with supervisor(s) and relevant functional counterparts to execute and review care models and workflows
• Advocate for case management and care coordination work as an important contributor for driving programme and hospital objectives
• Work closely with Ops counterparts when necessary to improve programme
• Work closely with other stakeholders/ professional job groups to continually integrate and optimise care manager work in relation to other workflows by the rest of the care team to optimise patient experience

Case management and care coordination

• Understand patient's medical, psycho-social and functional needs in collaboration with the multidisciplinary care team to ensure alignment with the patient's overall goals
• Initiate conversations with patient, if required, to identify potential care gaps
• Promote and guide positive changes in patient’s lifestyle to stay healthy in the community
• Advocate for advance care planning and facilitate discussions between patients and caregivers, ensuring that their preferences are reflected in their individualized care plans
• Suggest interventions and appropriate referrals to transitional care, including but not limited to VCC, ESD, NUHS@Home, NUHS Community Care Team (NUHS CCT), and community support services in discussion with patients and caregivers
• Follows up on patients in a timely manner to ensure smooth care transitions
• Follows through the workflow processes to maintain consistency, ensure accountability, and accurate documentation
• Participate in case discussions and sharing sessions with the rest of C3U to encourage consistent learning and prompt sharing of updates

One Referral Point for transitional services and support in community

• Understands the inclusion and exclusion criteria for community case and transitional care referrals. Triage all referrals received via the hospital messaging system and allocate appropriate patients to members within the One with Community Team.
• Updates database in an accurate and timely manner. Follow-up with assignment of referral to the relevant Care Manager where appropriate.
• Acknowledge and responds to the referral source via the hospital messaging system accordingly.

Other Responsibilities

• Keep updated about the details of transitional care and community support services available
• Seeks collaborations with internal and external transitional care and community support service providers
• Provides supervision and support to Care Coordinators and Care Coordinator Associates in their clinical work
• Participate in professional development programmes to enhance areas of knowledge, skills and expertise
• Support community-based events organized by Alexandra Hospital or community partners to raise awareness and promote public health
• Participate and contribute to the department’s quality improvement efforts and research
• Participate and contribute to the department’s learning and education activities
• Any other duties as assigned by Reporting Officer

Requirements

Qualification Required and Area of Discipline

• Degree or equivalent professional qualifications in Nursing, Social Work or Allied Health.
• Those with nursing or case management or related field in acute and/or community setting in Singapore is preferred.

Required Competencies and Capabilities (Skills, Experiences and Professional Licences)

• Minimally 5 years of work experience in healthcare industry.
• Experience working with and/or co-developing programmes or projects with clinicians and care team members will be an advantage.
• Knowledge in hospital specialised medical or surgical services, such as rehabilitative medicine, psychological medicine, surgical specialties, etc, and experience in home medical care and community will be an advantage.
• Strong team-player, with natural ability to interact with healthcare staff and community partners of all levels.
• Organised, analytical, able to fit different pieces of the puzzle together.
• Pleasant disposition, approachable, with strong interpersonal and relational skills.
• Good verbal and written communication skills. Ability to use local languages and dialects will be an advantage, especially coupled with experience interacting with and managing patients and caregivers.
• Independent worker, with strong initiative.
• Comfortable with ambiguity, unchartered territory, enjoy challenges and problem solving.
• Equipped with basic computer skills in MS Words, Excel and PowerPoint. Familiarity with hospital computer systems is advantageous.

*Only Singapore Citizens and Singapore Permanent Residents may apply.