Community Care Manager: Transitions & Education

hhccareers; Wethersfield (CT); On-site; USD 75,000 - 95,000; Full time

Job summary

Hartford HealthCare's Integrated Care Partners seeks a Community Care Manager to join the ICP Community Care Management team. You will facilitate transitions as patients move between care levels, ensuring uninterrupted quality care and ongoing education for attributed patients with chronic conditions.

You will perform transition of care services, participate in discharge planning, collaborate with inpatient teams and primary care providers, identify community resources, and educate patients and

Qualifications

• Bachelor’s in Nursing or Master’s in Social Work required.
• Minimum 2 years of experience in a healthcare setting.
• Current Connecticut RN License or other healthcare license as deemed appropriate.

Responsibilities

• Performs transition of care services for ICP attributed patients admitted to acute inpatient settings.
• Participates in care planning, family, and discharge planning meetings throughout patient’s inpatient stay.
• Partners with inpatient care coordination team to address discharge barriers and provides timely communication to the patient’s PCP.
• Collaborates with other Hartford HealthCare system partners upon patient’s discharge from acute inpatient setting to the community.
• Identifies resources within HHC system and larger community to address patient care needs.
• Provides education for patients, families, community, and other professionals regarding disease prevention, impact of illness and health maintenance.

Skills

Compassion for patients

Medical terminology

ACO knowledge

Healthcare reform

Feedback openness

Customer focus

Independent and team work

Education

Bachelor’s degree in Nursing

Master’s degree in Social Work

Job description

Hartford HealthCare's Integrated Care Partners seeks a Community Care Manager to join the ICP Community Care Management team. You will facilitate transitions as patients move between care levels, ensuring uninterrupted quality care and ongoing education for attributed patients with chronic conditions.

You will perform transition of care services, participate in discharge planning, collaborate with inpatient teams and primary care providers, identify community resources, and educate patients and