Care Manager - Geriatric Primary Care Schoolcraft

Trinity Health; Livonia (MI); On-site; USD 75,000 - 95,000; Full time

Benefits offered by this job

Day-one benefits

Work-life balance

Opportunities for advancement

Job summary

Trinity Health IHA Medical Group is seeking a compassionate Care Manager to join our outpatient team. You will guide patients through their healthcare journey with clinical triage, care coordination, and ongoing education to improve outcomes and the patient experience.

The role emphasizes collaboration with the health care team, self-management support for at-risk patients, and transitions of care to prevent readmissions. Oncology experience and CCM/CCP certification are valued.

Qualifications

• RN graduate with valid Michigan license and CPR certification.
• 3–5 years of clinical oncology care experience in primary/ambulatory care, home health, SNF, or hospital within the last five years.
• CCM/CCP certification preferred but not required.

Responsibilities

• Collaborate with the health care team and patient to provide quality, efficient, patient-centered, and cost-effective services.
• Provide self-management support and patient education to at-risk patients to prevent chronic conditions.
• Deliver targeted interventions to avoid hospitalization and ER visits; ensure proper triage within protocols.
• Assess, plan, implement, monitor, and evaluate individualized patient care to optimize health.
• Assist with transitions of care for hospitalized patients to reduce readmissions.
• Coordinate care across the continuum with the team to optimize resource use and outcomes.

Skills

Care coordination

Clinical triage

Patient education

Chronic disease management

Oncology care

Education

Registered Nurse program graduate (RN)

Job description

Employment Type: Full time

Shift: Day Shift

Description: Make a Meaningful Impact Beyond the Bedside!

Trinity Health IHA Medical Group is seeking a compassionate and patient-focused Care Manager to join our outpatient care team. In this role, you'll help patients navigate their healthcare journey through clinical triage, care coordination, patient education, and ongoing support that improves outcomes and enhances the patient experience.

What You'll Do:

• Collaborates with members of the health care team and patient to ensure the delivery of quality, efficient, patient centered, and cost effective healthcare services.
• Assists patients who are at risk for developing chronic conditions to minimize these risks by providing self-management support and patient education; Empowers patients to manage their health
• Provides targeted interventions to avoid hospitalization and emergency room visits; in specialty population the care manager ensures proper triaging of the patient and appropriate delivery of care in accordance with established protocols.
• Assesses, plans, implements, monitors, and evaluates delivery of individualized patient care with the goal of optimizing the patient’s health status.
• Participates in the outreach and engagement of patients that are hospitalized to assist with the transition of care and provides support and education to avoid further readmissions.
• Coordinates the care and services of selected member populations across the continuum of care, promotes effective utilization and monitoring of health care resources, and assumes a collaborative role with all members of the healthcare team to achieve optimal clinical and resources outcomes.

What We're Looking For:

• EDUCATION: Graduate of an accredited Registered Nurse program.
• CREDENTIALS/LICENSURE: Valid, unrestricted RN license in the State of Michigan. Valid CPR certification. Prefer CCM/CCP certification.
• MINIMUM EXPERIENCE: 3-5 years of clinical experience with oncology patients in primary care/ambulatory care, home health agency, skilled nursing facility, or hospital, within the past five years: knowledge of chronic conditions, evidence-based guidelines, prevention, wellness, health risk assessment, and patient education.

Why Join Trinity Health IHA Medical Group?

• Day-one benefits with no waiting period for eligible colleagues.
• Predictable outpatient schedule with a focus on work-life balance.
• Collaborative team environment with strong provider partnerships.
• Career growth, development, and advancement opportunities.
• Meaningful work improving the health of patients and communities across Southeast Michigan.

About Us

At Trinity Health IHA Medical Group, we're committed to delivering exceptional care through our core values of Commitment, Advocacy, Respect, Efficiency, and Service. If you're passionate about patient-centered care and want to make a difference every day, we'd love to have you join our team.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care.

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.