PeaceHealth is seeking a RN Complex Care Manager Outpatient for a 1.0 full time equivalent Exempt position. This position will be working Day shift with shift durations of 8 Hours .
Req ID: 163209
Oversees and evaluates coordination of integrated population management across selected populations to improve clinical and financial outcomes. Develops care management programs addressing a wide scope of health care needs and conditions in partnership with physicians, health care professionals and patients. Identifies, coordinates, and case manages a panel of clinically high-risk complex patients and provides oversight for caregivers who manage patients at moderate or low risk.
1. Accountable for development and continuous evaluation and assessment of population management programs, tools and delivery of care coordination services. Collaborates with system and regional leadership to optimize processes and metrics.
2. Risk-stratifies patients according to protocols, assesses patient data, and works within interdisciplinary care team to assess patient's physical, cognitive, emotional and behavioral status as well as social and financial support systems.
3. Works with patients and families to create and implement a care plan that meets identified needs and incorporates services that improve outcomes. Adjusts care plan to patient activation and risk levels through ongoing monitoring of patient.
4. Delegates and oversees the care management of lower-risk patients as well as routine chronic disease population management tasks to assigned caregivers.
5. Tracks, evaluates, and provides oversight for transitions of care, synchronizing
Internal Number: 163209
PeaceHealth Physicians are as diverse as the communities they serve, but have the following in common:Dedication to carrying on the healing mission of Jesus Christ by promoting personal and community health, relieving pain and suffering and treating each person in a loving and caring way.A shared vision of every patient receiving exceptional, compassionate evidence-based care, every time, every touch.