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Clinical Care Manager, High Risk Primary Care
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Genesis Medical Associates
Pittsburgh, PA (In Person)
$80,000 Salary, Full-Time
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Job Description
Genesis Medical Associates, Inc. is seeking a full-time Clinical Care Manager. The Clinical Care Manager is responsible for coordination of care, health education, and active collaboration of patients, their caregivers, and providers. Responsibilities include, but are not limited to: Assess the medical, behavioral, and social needs of the patients. Review health plan data and documentation in the electronic health records as appropriate, and identify gaps in care based on clinical standards of care. Refer patients to appropriate health management, educational, lifestyle, or self-management programs. Engage patients to successfully follow through with health care recommendations. Provide patients with appropriate educational materials or resources to enhance their knowledge and skills related to health or lifestyle management. Contact patients with gaps in preventive health care services and assist them to schedule required screening or diagnostic tests with their providers. Assist patients with scheduling follow up appointments after emergency room visits or hospitalizations. Review patient's current medication profile, identify issues related to medication adherence, and address any issues with the member and provider as necessary. Refer member for Comprehensive Medication Review as appropriate. Successfully engage patients to develop individualized care plans and goals in collaboration with their primary care provider that promotes healthy lifestyles, closes gaps in care, and reduces unnecessary ER utilization and hospital re-admissions. Coordinate and modify goals with patient, caregivers, PCP, specialists, community resources, behavioral health contractors, or other health plan/system departments as appropriate. Present or contribute to complex case reviews with patient care teams by summarizing clinical and social history, healthcare resource utilization, and/or case management interventions. Assist patients with transition of care between health care facilities including sharing of clinical information. Accurately document all activities and interventions in the electronic health record. Identify trends and opportunities for improvement based on information obtained from interaction with patients and providers. Candidate must be an RN with current licensure in the state of Pennsylvania. A minimum of 2 years of clinical and/or care management experience is required. Minimum 1 year of experience in health insurance preferred. Minimum 1 year of experience in utilization management, transitional care, home care, or discharge planning preferred. Must have excellent organizational skills, a high level of oral and written communication skills, and proficient computer skills. Comprehensive benefit package, including PTO, 401k profit sharing and free parking. Genesis Medical Associates is an EOE who provides the highest quality care possible to our patients.