Care Manager Nurse Job Description
Care Manager Nurse Duties & Responsibilities
To write an effective care manager nurse job description, begin by listing detailed duties, responsibilities and expectations. We have included care manager nurse job description templates that you can modify and use.
Sample responsibilities for this position include:
Care Manager Nurse Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Care Manager Nurse
List any licenses or certifications required by the position: BLS, CCM, ACLS, AHA, ACM, ABQAURP, CCRN, BCLS, PALS, CPR
Education for Care Manager Nurse
Typically a job would require a certain level of education.
Employers hiring for the care manager nurse job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Master's Degree in Nursing, Education, Science, Graduate, Nursing Education, Management, Department of Education, School of Nursing, Health Care Administration, Medical
Skills for Care Manager Nurse
Desired skills for care manager nurse include:
Desired experience for care manager nurse includes:
Care Manager Nurse Examples
Care Manager Nurse Job Description
- Ensures members receive an integrated plan of care using recovery principles
- Maintains an understanding of policies and procedures, in regards to services
- Makes recommendations for medically necessary services independently, within the scope of practice of held licensure
- Participates in professional development activities and integrate reliability activities
- Responsible to perform in home medication reconciliation as needed
- Works professionally with MCO and other internal staff Proficiency in operating computer software
- Works with members and providers, in the field, to customize services to best meet members needs within the scope of Community Care's obligations to its members
- Conducts all clinical assessments planning, and develops appropriate interventions and develops a care plan and care coordination (or oversight and supervision) for all assigned members receiving medical behavioral health services, including medication reconciliation within the member's home/community
- Create a neighborhood(s) and work environment that promotes and fosters a resident/patient directed service model with a team approach
- Select, hire, and evaluate staff and other team members with assistance from the neighborhood team
- Bachelor's Degree and/or Nurse license in related field of healthcare or business
- Three plus (3+) years experience in the healthcare industry within clinical or account management
- Requires ability to work day/night shifts, as needed
- Strong customer focus and relationship building
- Demonstrated ability to work both independently and collaboratively within teams
- Ability to manage time and priorities to meet deadlines
Care Manager Nurse Job Description
- Collaborate with other neighborhood coordinators and program managers to share resources, knowledge, expertise, opportunities, and achievements
- Keep supervisor fully informed of status, progress, and achievements
- Work flexible hours and shifts to meet 24 hour accountability and responsibilities
- To use critical thinking skills to influence the efficient direction of patient care for patients in the Emergency Department
- To coordinate and implement strategies made through a collaborative process between the Enterprise Care Management team in a timely manner
- To ensure that quality health care services are being delivered to meet an individual's specific healthcare needs in a cost effective manner
- To facilitate the appropriate utilization of resources and transition of patients to the most appropriate level of care along the continuum, through efficient communication between internal and external parties
- Manages the transition of assigned Post Acute patients from acute care setting to the skilled nursing facility and/or home setting utilizing face to face and telephonic outreach to accomplish the goals of the Post Acute Program
- The Nurse Care Manager will also communicate patient plan of care and discharge status with the Primary Care Physician and/or Specialist
- Acts as a clinical resource for unlicensed Post Acute Care Coordinators, providing clinical expertise and helping to clarify referral source directives
- At least 5 years experience in Telemetry/Progressive Care
- Bachelor’s Degree in Nursing (BSN) from an accredited school of nursing
- Participates in performance and operational improvement activities
- Must be willing to travel 75% of the time within assigned geography and occasionally to central CareCentrix locations
- Current and unrestricted license for the market (state) of practice as a Registered Nurse
- This position requires high level clinical knowledge, communication, customer service and problem solving skills, , the ability to effectively interact with all levels of management and a highly diverse clientele
Care Manager Nurse Job Description
- Collaborate with available resources to facilitate adherence to the care plan, such as chronic disease specialists and any provider/payer based clinical programs
- Assist care team to close preventative and chronic disease care gaps by communicating with the healthcare team and informing them of any progress and potential barriers
- Participate in quality improvement projects aimed at improving population outcomes and associated processes
- Attends team meetings as appropriate
- Complies with confidentiality policies, HIPAA, NCQA and other regulatory agency requirements
- Works collaboratively with the interdisciplinary team to promote high quality care provided in a timely and fiscally responsible manner
- Ability for clinical staff to utilize skills in moderate sedation, cardiac arrhythmia identification and treatment, universal protocol, core measures, and trach care
- Leading and organizing the delivery of care to assure continuity and accountability
- Using advanced clinical knowledge and judgment to promote staff involvement in planning and executing care
- Act as an expert and resource to the staff in clinical practice in the procedural areas
- Must have a strong commitment to quality and standards
- Bachelors of Science Degree in Nursing preferred
- Proficient knowledge of NCQA, URAC, federal and state requirements Knowledge of Coordination of Care, Medicare regulations, prior authorization, level of care and length of stay criteria sets desirable
- Requires extensive experience in nursing (3-4 years acute clinical experience), 3 years utilization management preferred
- Experience in using computer-based tools
- Ambulatory Management Experience strongly preferred
Care Manager Nurse Job Description
- Evaluate the performance of employees in the procedural areas, making recommendations for promotion, advancement and reassignment
- Taking disciplinary action when necessary
- Hears and resolves complaints of subordinates and refers the more serious complaints, not resolved, to higher level supervisors
- Identifies developmental and training needs of subordinates and providing or making provision for such development and training (VA Handbook 5007, Part III, Chapter 8)
- Is responsible for performance improvement data, customer service/patient satisfaction, patient and employee safety, interviewing applicants, employee relations, standards of care and practice, the work environment, and accreditation and regulatory standards
- Participates on service and medical center committees and task forces to improve nursing practice and patient care
- Supervises the Float - Nursing Assistant section
- Will designate a cross-covering Nurse Manager in his/her absence to handle administrative and clinical issues, such as staffing coverage, granting leave, and patient and/or staff issues
- Supervises nursing staff in assessing, planning and evaluating the care of the clients based on acuity within a positive team environment
- Monitors and supervises the medication administration process ensuring that the clients receive prescribed medications and that documentation is completed according to policy and procedures
- Current/active WI RN License
- Experience with medical decision support tools
- Well developed telephonic problem solving skills
- Ability to engage or influence others to gain acceptance of an idea, plan or activity
- Ability to assess both physical and psychosocial problems
- Minimum of BSN, MSN preferred
Care Manager Nurse Job Description
- Maintains accurate, detailed reports of client records
- Monitors and supervises all aspects of client’s care to ensure that quality nursing care is being provided according to approved standards
- Audits client’s records periodically to ensure that nursing care and documentation complies with hospital standards
- Develops therapeutic relationships with the clients and report any form of abuse to the authority
- Assists and participates in the development of educational programs for the clients and staff
- Manages Human Resource functions as they relate to hiring, employee relations and disciplinary actions according to policies and procedures
- Maintains current trends in nursing, participates in hospital and departmental meetings conducts unit meetings regularly
- Clarifies plan medical benefits, policies and procedures for members, providers and community based agencies
- Adhere to documentation policies and procedures including documentation of clinical assessment activities and their effectiveness
- Develops proactive course of action to address issues to optimize the short & long-term outcomes, members overall well-being and quality of life Implements/coordinates care management activities relating to acute cases & chronically ill members/clients across the continuum of care including education, referrals, connections to community resources, care coordination & support for transition to alternative levels of care
- 5 years of clinical experience plus 3 years of experience in a community-based practice, health plan, hospital, or the equivalent required with preference for case management or care coordination experience
- Experience in acute inpatient, rehabilitation, sub-acute, skilled facility, home care, ambulatory care or managed health preferred
- Experience in multi-modality technology and/or motivation & willingness to become adept to using technology
- Experience in Care Management, Case Management or Disease Management
- Two to five years’ work experience in a Registered Nurse role
- Experience managing complex patients in an ambulatory setting preferred