RN Care Manager Population Management

UNC Health; Chapel Hill (NC); Presencial; USD 70 000 - 90 000; Tempo integral

Resumo da oferta

The Care Manager RN at UNC Health in Chapel Hill (and nearby Mebane) coordinates comprehensive care for patients in primary care settings. You will perform risk assessments, develop patient-centered care plans, and work with clinicians, patients, and families to improve outcomes.

This role emphasizes care transitions, payer communication, documentation, and participation in quality improvement. A North Carolina RN license and 2+ years of experience are required, with BSN preferred.

Qualificações

• Minimum of 2 years of experience as a registered nurse.
• Licensed to practice as a Registered Nurse in North Carolina.
• BSN preferred or enrolled in accredited program within 4 years of employment.

Responsabilidades

• Conduct comprehensive care manager assessments using standardized tools and nursing knowledge.
• Develop individualized, evidence-based care plans aligned with patient goals and values.
• Identify barriers to care and coordinate appropriate interventions.
• Coordinate tasks and interventions with the care team and community resources.
• Facilitate care transitions across healthcare settings to ensure continuity.
• Document and bill for services; ensure coding and regulatory compliance.
• Participate in quality improvement initiatives to meet organizational goals.

Conhecimentos

Risk segmentation

Patient assessments

Patient-centered care planning

Care transitions

Payer communication

EHR proficiency

Communication skills

Formação académica

Graduation from a state accredited school of professional nursing

BSN preferred or enrolled in accredited program within 4 years of employment and obtain degree within 7 years

Ferramentas

EHR systems

Descrição da oferta de emprego

Description

Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.

*This position will be assigned to support two primary care clinics, one in Chapel Hill and the other in Mebane.

Summary

The Care Manager RN plays a crucial role in providing comprehensive and coordinated care to patients within UNC Health. This position involves utilizing a variety of skills, including risk segmentation, patient assessments, patient-centered care plans, tasks or interventions, care transitions, delegated work, and payer communication. The Care Manager works collaboratively with healthcare providers, patients, and their families to ensure that patients receive the highest quality of care and support throughout their healthcare journey.

Responsibilities

1. Patient Assessments
   • Conduct comprehensive care manager assessments utilizing standardized assessment tools and nursing knowledge to evaluate patients' functional abilities, cognitive status, and psychosocial support systems.
   • Identify any barriers to care and develop appropriate interventions to address them.
2. Patient-Centered Care Plans
   • Collaborate with providers, patients, their families, and the healthcare team on individualized care plans that align with patients' goals, preferences, and values.
   • Ensure that care plans are evidence-based, culturally sensitive, and promote patient engagement and self-management.
3. Risk Segmentation
   • Utilize standardized tools and clinical judgment to identify and assess the risk level of patients based on various factors such as medical conditions, social determinants of health, and behavioral health needs.
   • Develop strategies to effectively manage and mitigate risks for patients, ensuring their overall well-being and optimal health outcomes.
4. Tasks or Interventions
   • Coordinate and facilitate necessary tasks or interventions to support patients' care plans.
   • Collaborate with healthcare providers, community resources, and support services to ensure seamless coordination of care.
   • Advocate for patients' needs and rights, ensuring that they receive appropriate and timely interventions.
   • Participates in quality improvement initiatives to ensure patient, departmental, and organizational goals/outcomes are met or exceeded.
5. Care Transitions
   • Coordinate and facilitate care across various healthcare settings, ensuring seamless transitions and continuity of care.
   • Communicate and collaborate with healthcare providers, specialists, and community resources to ensure comprehensive and coordinated care delivery.
   • Facilitate multidisciplinary care team meetings to discuss patients' care plans and progress.
6. Coordinated Work
   • Coordinate care management tasks with other members of the healthcare team while maintaining accountability for the overall coordination and management of patients' care as applicable per patient population.
7. Payer Communication
   • Collaborate with payers, insurance companies, and utilization management teams to optimize reimbursement and facilitate timely approvals for necessary care and services.
8. Accurately document and bill for services rendered, as applicable, in compliance with insurance and regulatory requirements
   • Collaborate with billing and coding professionals, as applicable, to ensure compliance with coding and documentation requirements.
9. Longitudinal Care as part of the Medical Home (varies per patient population and care setting)
   • Act as a key point of contact and advocate for patients within the care team.
   • Provide ongoing support and care coordination throughout the patient's healthcare journey, ensuring continuity and comprehensiveness of care.

Other information:

Education Requirements:

• Graduation from a state accredited school of professional nursing
• Magnet hospitals: BSN required or must be enrolled in an accredited program within 4 years of employment and obtain a bachelor's degree with a major in nursing or a master's degree with a major in nursing within 7 years of employment date.

Licensure/Certification Requirements:

• Registered Nurse with a valid license to practice in North Carolina.

Professional Experience Requirements:

• Minimum of 2 years of experience as a registered nurse.

Knowledge/Skills/and Abilities Requirements:

• Strong knowledge of risk segmentation, patient assessments, patient-centered care planning, care transitions, and payer communication.
• Excellent communication, collaboration, and problem-solving skills.
• Ability to work independently and as part of a multidisciplinary team.
• Proficiency in electronic health records (EHR) and other relevant software applications.

Job Details

Legal Employer: NCHEALTH

Entity: Health Alliance

Organization Unit: Pop Health Care Management

Work Type: Full Time

Standard Hours Per Week: 40.00

Pay offers are determined by experience and internal equity

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: US:NC:Chapel Hill

Exempt From Overtime: Exempt: Yes

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Heath Care System. This is not a State employed position.

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities.