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Nurse Complex Care Manager in Philadelphia, PA at Public Health Management Corporation

Date Posted: 12/7/2018

Job Snapshot

Job Description

Our Mission is to be the premier regional provider of integrated, community-based healthcare by combining evidence-based clinical practices, outstanding patient service, innovative care partnerships, and team-driven excellence, within a healthy fiscal environment.

Provide complex care management to patients in community based, nurse- managed health center to diverse and underserved populations. Complex Care Manager will report Quality Nurse Manager.

Essential Duties and Responsibilities: 

  • Supervises the Complex Chronic Care Management Team for the various insurance companies Patient Centered Medical Home Programs. The Complex Chronic Care Management Team works with patients and staff across the six PHMC health centers.
  • Gathers and organizes data and information needed for the different insurance companies based on their Patient Centered Medical Home Program.
  • Ensuring all identified patients are assessed appropriately and individualized care plan are initiated with the team which includes health conditions, treatments, behaviors, risks, support resources, values, preferences and overall needs to develop care plan then work with patient/caregiver/co-learner/providers to develop goals, informs care team if inappropriate for complex care and makes recommendations for care plan in usual care team.
  • Assesses patient readiness for transition back to health center care team or to more intensive level of care
  • Holds regular IDT meetings with complex care team, patient provider, RN care manager, BHC and any other appropriate staff member.
  • Ensures patient assessments, health education, health screenings, and other disease prevention programs are completed.
  • Serves as complex care manager for patients with complex chronic health problems as identified by the insurance companies and/or referred by a SHS provider.
  • Records care provided within electronic medical record and completes other assigned reports.
  • Works within all state and federal laws and regulations.
  • Notifies immediate supervisor of significant problems.
  • Maintains positive relationships with funding sources and community organizations.
  • Performs other tasks as directed and needed.

PHMC Compliance Responsibilities: 

  • Understands and adheres to PHMC compliance standards as they appear in the PHMC Code of Conduct, Whistle Blowers and Conflict of Interest Policies.
  • Keeps abreast of all pertinent federal, state and PHMC regulations, laws, and policies as they presently exist and as they change or are modified.
  • Comply with HIPAA and Confidentiality Policies and Procedures as they apply to the job.
  • Comply with Department of Public Health (DPH), The Joint Commission and other accreditation and regulatory agencies standards.
  • Adhere to all PHMC Policies and Procedures.
  • Knowledge and adherence to Infection Control and Environment of Care Guidelines and Procedures as described in the annual education module.

 Job Requirements: 

  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Skills: 

  • Strong written and verbal communication skills
  • Ability to work with diverse staff in an urban setting
  • Current CPR certification
  • Ability to maintain comprehensive, accurate and timely nursing documentation

EXPERIENCE: 

  • Four- year experience preferred in primary care, community health and/or behavioral health
  • Experience with homeless people, and a diverse population
  • Case management experience
  • Demonstrated abilities performing comprehensive nursing assessments

EDUCATION: 

  • BSN Required.
  • Pennsylvania RN License Required

PHYSICAL DEMANDS: 

Position requires standing 2/3 of the time, walking 2/3 of the time, requires sitting under 1/3 of the time, use of hands to finger, handle or feel 2/3 of the time, reach with hands and arms, under 1/3 of the time, stoop, kneel, crouch or crawl under 1/3 of the time, talk or hear over 2/3 of the time. Position requires lifting up to 10 lbs. up to 1/3 of the time.

WORK ENVIRONMENT: 

Moderate noise (examples: business office with computers and printers, light traffic). Exposure to blood borne pathogens that requires use of personal protective equipment.

SALARY:  Grade 21