Registered Nurse Care Manager
Position
Summary:
The RN Care Manager, as part of an interdisciplinary team (IDT), serves frail elders, adults with physical disabilities and adults with developmental disabilities who are members of the District. The team's goal is to promote the overall well-being of the members the District serves by providing high quality, person-centered, outcome based care.
Under general direction, this position provides care management and service coordination services to District members. As a member of the IDT, the care manager arranges for provision of services and supports based on a comprehensive assessment of the member's identified outcomes and needs. The IDT monitors the provision of services based on the member-centered plan per District policy and procedures, and Department of Health Services (DHS) contract requirements.
Principal Duties and
Responsibilities:
The following duties are typical for this position. These are not to be construed as exclusive or all inclusive. Other duties may be required and assigned.
o As part of an interdisciplinary team (which also includes a care manager and the member and/or legal representative) participate in a comprehensive assessment of the member's outcomes and needs; revises the assessment as members' outcomes and needs change.
o Develop, coordinate and monitor members' outcome-based individual service plans, considering cost in designing services and choosing providers.
o Provide nursing care in accordance with the Nurse Practice Act.
o Create and maintain member records as dictated by the Department of Health Services (DHS) contract and District standards. Conduct comprehensive health assessments.
o Participate in State and Federal reviews of member centered plans; develop member-centered plans when directed within the designated timeframes.
o Coordinate and participate in regularly-scheduled meetings involving the member, their circle of support and providers.
o Inform members of changes, deletions, and denials of services as dictated by the DHS contract. Inform members of their rights to grieve and appeal, and facilitate member's participation in the grievance/appeal process.
o Assist the member and their family in identifying community resources.
o With the care manager, coordinate acute and primary care services provided to members. This may include arranging for and/or attending medical appointments, attending discharge planning conferences and coordinating follow-up services.
o Monitor quality and effectiveness of services provided to members. Report any discerned provider quality issues or gaps in the provider network to the Provider Network staff.
o Participate in 24-hour on-call as directed.
o Participate in initial orientation and training as directed; participate in ongoing training and education opportunities, both internally and externally, with approval.
o As directed, participate in workgroups related to quality improvement, policy and procedure development, prevention and wellness, member relations etc.
o Participate in regularly-scheduled team meetings.
o Follow District organizational policies and procedures.
o Follow Universal Precautions and all other OSHA-required programs and procedures.
o Comply with applicable federal and state laws, administrative rules, established agency procedures and accepted professional standards.
o Participate in on-going training; maintain contemporary knowledge to ensure compliance with Federal and State regulations.
o As directed, represents District to the community at large through professional interaction, clinical consultation, public speaking, media presentations, and participation in community advisory groups as requested.
o Maintain the confidentiality of member information and protected health information (PHI) as required by State and Federal regulations, including the Health Insurance Portability and Accountability Act (HIPAA) of 1996.
Work Relationships and Scope:
The Care Management Supervisor provides general direction for this position. Decisions are made within the policies and procedures established by the District. There is significant interaction with other professionals, both inside and outside the District. In addition to interacting frequently and directly with District members, this position also interacts regularly with care managers, District staff, professionals from outside agencies and medical personnel.
Knowledge, Skills and Abilities:
o Current License to practice as a Registered Nurse in the State of Wisconsin.
o Bachelor's degree in nursing strongly preferred.
o Two (2) or more years of skilled nursing experience required, preferably in gerontology/disabilities and/or home care.
o Ability to access members' homes which may or may not have accommodations for individuals having disabilities.
o Ability to lift up to 25lbs.
o Current WI driver's license, acceptable driving record and proof of adequate insurance.
Working Conditions:
Work is performed in two primary settings: member visits occur in homes, assisted living facilities and the like; most other work is completed in a general office environment. Work hours are generally during normal business hours; however, unscheduled evening and weekend work may occasionally be necessary to meet members' needs and/or the needs of the organization. Periodically provides 24-hour on-call support. Travel is required - frequently throughout the County where position is based, as well as occasionally outside of the County.
Acknowledgement:
This position description describes the general nature and level of work performed by the individual assigned to this position and should not be interpreted as all inclusive. It does not state or imply these are the only duties and responsibilities assigned to the position. The employee may be required to perform other job-related duties. All requirements are subject to change and to possible modification to reasonably accommodate individuals with a disability.
This position description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the position change.Estimated Salary: $20 to $28 per hour based on qualifications.
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