Overview

The RN Care Manager coordinates care for a caseload of primary care patients using phone or telehealth platforms. Working in collaboration with other members of the care team, The RN Care Manager assesses the patient's needs and develops individualized care plans in alignment with patient goals for their care.  The RN Care Manager provides education to patients and their families/caregivers on how to manage chronic conditions, medication usage, and reporting symptoms needing early intervention.

 

Location: Merrifield, VA

 

Schedule: Monday - Friday 8:30-5:00

 

COVID-19 vaccine required to be completed upon start

Responsibilities

The RN Care Manager also provides referrals to community resources to meet the psychosocial needs of patients.  He/she demonstrates empathy, excellent communication skills and the ability to think critically as a member of the interdisciplinary team. The Case Manager also has technical competency in the use of computer systems and applications, including the Electronic Health Record.

 

Quality Provision of Services:   

Schedules and conducts routine telephonic visits with patient and/or caregiver to perform care management services.

Completes assessments with each patient to identify clinical and psychosocial needs and risks that impact health status.

Works with all stakeholders to create individualized care plans to meet clinical and psychosocial needs while maximizing healthcare responses, quality and cost-effective outcomes.

Facilitates communication and coordination among stakeholders, involving the patient in the decision-making process to minimize service fragmentation.

Assists the client in safe transitions across care settings.

Manage and triage incoming calls from patients or caregivers with back up from other team members as needed.

Completes all required documentation in the electronic health record at the time of service.

Assists with the development and implementation of goals, objectives, priorities and projects for the Applications Team.

Cross trains and assists in other areas of the Innovations HUB as requested.

Qualifications

Experience RequirementsMust have 3 years of RN experience, with 1 year as a Care/Case Manager. Geriatrics or primary care experience desired.

 

Education RequirementsMust have a degree in Nursing from an accredited nursing program. A BSN degree is preferred.

 

Required Certificates and/or Licenses:

Must have an active RN license in the state of service. Healthcare Provider BLS (CPR) is required to practice in the State of Maryland and the District of Columbia. Case Management certification is preferred.

 

Driver's License

Must have a driver's license in good standing and access to a vehicle during working hours.