RN Care Manager

Summit Health•Atlanta, GA

8d•Hybrid

About The Position

As an RN Care Manager with VillageMD, you will help us achieve our goals by collaborating with providers and engaging with high risk patients to develop a patient-centered care plan focused on management of chronic conditions and measured by clinical indicators. You will work closely with the entire Care Management team, including Care Coordinators, Nurse Navigators and Social Workers, to connect the dots of collaborative patient care while incorporating patients’ personal health and lifestyle goals. What are some unique responsibilities that you’ll have at VillageMD? You will spend much of your week embedded in the physician office working directly with providers and engaging high risk patients Involve high risk individuals in activities to improve their health and partner with the care team to establish identified goals and action steps to focus on wellness, improve management of overall health and reduce unnecessary utilization Utilizing your clinical knowledge and deep understanding of key community resources, you’ll provide health education and coordinate consults and referrals to support patients and facilitate continuity of care What will make you successful here? The ability to be flexible in an ambiguous and dynamic environment A service orientation and a positive, “can-do” attitude, along with the desire to work as part of a team A willingness to learn on your own and take initiative A low ego and humility; an ability to gain trust through good communication and doing what you say you will do Confidence in learning and using a variety of technology tools, applications and systems Strong communication, time management and organizational skills What you might do in your first year: Develop relationships with primary care practice care teams to operate as an extension of the provider in supporting high risk patients Engage a caseload of high-risk patients in Care Management, set patient-specific goals and provide interventions to help them better manage their health Participate in grand rounds and other meetings with provider partners and VMD leadership to discuss patient care and improvements to care team processes

Requirements

3+ years of direct, clinical nursing experience
Registered Nurse with licensure in the state of practice
Care management or transitional care management experience in a setting that requires assessment, critical thinking and application
Comfort with technology, including Microsoft suite of products
Proficiency in utilizing a variety of electronic health records including data capture, data mining and reporting

Nice To Haves

Case Management Certification is preferred, but not required

Responsibilities

Collaborate with providers and engage with high risk patients to develop a patient-centered care plan focused on management of chronic conditions and measured by clinical indicators.
Work closely with the entire Care Management team, including Care Coordinators, Nurse Navigators and Social Workers, to connect the dots of collaborative patient care while incorporating patients’ personal health and lifestyle goals.
Spend much of your week embedded in the physician office working directly with providers and engaging high risk patients.
Involve high risk individuals in activities to improve their health and partner with the care team to establish identified goals and action steps to focus on wellness, improve management of overall health and reduce unnecessary utilization.
Provide health education and coordinate consults and referrals to support patients and facilitate continuity of care, utilizing clinical knowledge and deep understanding of key community resources.
Develop relationships with primary care practice care teams to operate as an extension of the provider in supporting high risk patients.
Engage a caseload of high-risk patients in Care Management, set patient-specific goals and provide interventions to help them better manage their health.
Participate in grand rounds and other meetings with provider partners and VMD leadership to discuss patient care and improvements to care team processes.