Care Manager - Health Quality Partners - Full-Time - Days
Apply NowCompany: Doylestown Health
Location: Stonyford, CA 95979
Description:
Job Description:
PURPOSE OF JOB
To provide comprehensive, person-centered, longitudinal community based preventive care and care
management (CM) interventions for participants and families. Effectively engage, assess, monitor, educate
and provide interventions for participants and families to improve the quality of care, participant health
outcomes, and reduce unnecessary health care utilization. Collaborate with physicians, hospitals, skilled
nursing facilities, home health providers and community services to advocate for patient needs, to promote
better health, and to prevent unnecessary hospital utilization.
II. ESSENTIAL FUNCTIONS
1. Independently completes comprehensive advanced level nursing assessments that include focused
physical examinations with attention to common geriatric syndromes. Practice incorporates a
sophisticated knowledge of evidence-based, best practice standards of care for chronically ill older
adults. Uses clinical knowledge and sound judgment to identify subtle changes in participants'
status, and anticipates and intervenes to prevent problems and complications.
2. Effectively engages, assesses and provides interventions and support for participants, their families and
caregivers to address medical, health, social, psychological, environmental and lifestyle issues; with
the goal of improving health and preventing unnecessary hospital utilization. Interventions are
delivered through one on one inperson contact with participants and families in their home, in
physician offices, in groups, and through follow-up monitoring by telephone.
3. Collaborates with physicians, hospitals, skilled nursing facilities, home health care providers and
community service agencies to coordinate and improve the care for participants. Effectively
communicates with healthcare providers and advocates for participants from an individualized
person-centered perspective.
4. Demonstrates extraordinary teamwork to meet the dynamic needs of the participants and of the team
and program, in a fast paced, dynamic and learning environment. Incorporates HQP's program
principles into practice (person centered; a robust set of population relevant interventions; reliable;
anticipatory and accountable).
Job Qualifications:
QUALIFICATIONS & REQUIREMENTS
Education: RN with Bachelors or Masters of Science in Nursing preferred
Experience: Minimum five years of current clinical experience, ideally in one or more of the following areas or
specialty practice: medical-surgical, home care, hospice, community health, rehabilitation, long term care,
cardiovascular, diabetes, and or pulmonary diseases, oncology and geriatrics.
Other Knowledge and Skills:
? Current clinical knowledge in geriatrics, chronic diseases, heart failure, heart disease, COPD, diabetes and other co-morbidities.
? Proficiency with electronic documentation keyboarding
? Demonstrated ability to function independently with sound clinical and professional judgment
? Must be a self-initiator with high energy/productivity and a strong work ethic
? Proven history as a team player
? Flexibility and adaptability in managing multiple priorities, changing schedule
? Excellent communication skills (written and verbal)
? Excellent organizational and time management skills
Additional Requirements:
PA and NJ (or eligible) RN license
Basic Life Support (BLS) certification
Must have own vehicle for daily travel throughout the HQP service region
Must maintain and provide proo f of a valid driver's license
Must have, maintain and provide proof of automobile insurance coverage as required by law
PURPOSE OF JOB
To provide comprehensive, person-centered, longitudinal community based preventive care and care
management (CM) interventions for participants and families. Effectively engage, assess, monitor, educate
and provide interventions for participants and families to improve the quality of care, participant health
outcomes, and reduce unnecessary health care utilization. Collaborate with physicians, hospitals, skilled
nursing facilities, home health providers and community services to advocate for patient needs, to promote
better health, and to prevent unnecessary hospital utilization.
II. ESSENTIAL FUNCTIONS
1. Independently completes comprehensive advanced level nursing assessments that include focused
physical examinations with attention to common geriatric syndromes. Practice incorporates a
sophisticated knowledge of evidence-based, best practice standards of care for chronically ill older
adults. Uses clinical knowledge and sound judgment to identify subtle changes in participants'
status, and anticipates and intervenes to prevent problems and complications.
2. Effectively engages, assesses and provides interventions and support for participants, their families and
caregivers to address medical, health, social, psychological, environmental and lifestyle issues; with
the goal of improving health and preventing unnecessary hospital utilization. Interventions are
delivered through one on one inperson contact with participants and families in their home, in
physician offices, in groups, and through follow-up monitoring by telephone.
3. Collaborates with physicians, hospitals, skilled nursing facilities, home health care providers and
community service agencies to coordinate and improve the care for participants. Effectively
communicates with healthcare providers and advocates for participants from an individualized
person-centered perspective.
4. Demonstrates extraordinary teamwork to meet the dynamic needs of the participants and of the team
and program, in a fast paced, dynamic and learning environment. Incorporates HQP's program
principles into practice (person centered; a robust set of population relevant interventions; reliable;
anticipatory and accountable).
Job Qualifications:
QUALIFICATIONS & REQUIREMENTS
Education: RN with Bachelors or Masters of Science in Nursing preferred
Experience: Minimum five years of current clinical experience, ideally in one or more of the following areas or
specialty practice: medical-surgical, home care, hospice, community health, rehabilitation, long term care,
cardiovascular, diabetes, and or pulmonary diseases, oncology and geriatrics.
Other Knowledge and Skills:
? Current clinical knowledge in geriatrics, chronic diseases, heart failure, heart disease, COPD, diabetes and other co-morbidities.
? Proficiency with electronic documentation keyboarding
? Demonstrated ability to function independently with sound clinical and professional judgment
? Must be a self-initiator with high energy/productivity and a strong work ethic
? Proven history as a team player
? Flexibility and adaptability in managing multiple priorities, changing schedule
? Excellent communication skills (written and verbal)
? Excellent organizational and time management skills
Additional Requirements:
PA and NJ (or eligible) RN license
Basic Life Support (BLS) certification
Must have own vehicle for daily travel throughout the HQP service region
Must maintain and provide proo f of a valid driver's license
Must have, maintain and provide proof of automobile insurance coverage as required by law