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Lead Care Management

Job ID: 136002
FT
Bala Cynwyd, PA, United States
Jun 1, 2022

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Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Summary:

  • The Lead, Care Management is responsible for managing a regional team of staff (Clinical Care Managers and Social Workers) that are dedicated to promoting organizational values of patient and visitor satisfaction by demonstrating courtesy and respect for families, visitors and other employees. The incumbent will also maintain a clinical caseload of patients by collaborating with practices to provide clinical support to "high-risk" patient populations for multiple practices in all age groups ranging from young adulthood through geriatrics. This role will include face to face (travel required), telephone or telehealth encounters as appropriate to staff member and/or patient needs.

Responsibilities:

  • Clinical Responsibilities:
  • Designs and implements care management support activities for high risk patients with chronic diseases and high medical service utilization.
  • Collaborates with physician and practice staff in identifying appropriate patients for care management utilizing established criteria. Collaborates with the patient and provider to establish and implement a care management plan using evidence-based guidelines. Develops patient objectives and measures progress according to standards of care.
  • Triages patient telephone calls and provides consultation regarding ongoing symptom management resulting from treatment and disease, analysis of intervention regarding diagnostic work-up, assessing and managing acute emergencies, managing family concerns as needed, liaison activities with affiliated physicians, nurses, pharmacists and emergency rooms.
  • Initiates appropriate evaluation and management of emergency situations.
  • Coordinates patient’s management/treatment plan throughout the institution.
  • Instructs patient/family regarding medications and treatments. Educates patients regarding health and illness prevention. Recommends community resources to meet patient and family needs. Develops patient education programs.
  • Creates, uses, and maintains patient-specific care management tracking system that identifies/ reports on patients who will benefit from care management services, the subsequent patient progress, and associated interventions.
  • Supports QA and maintenance efforts for patient registries and quality reporting. Works with the Clinical Analyst to summarize and analyze data from registries
  • Promotes patient self-management and empowers patient and families to achieve optimal health outcomes. Assists patient to identify and/ or develop and utilize their support systems.
  • Evaluates the effectiveness of care management plan in meeting established care goals and revises the plan as needed to reflect changing needs, issues and goals.
  • Prepares and maintains appropriate documentation as required.
  • Collaborates with all members of the health care team to resolve patient health, social, or behavioral health needs.
  • Provides monitoring and continuity of care between physician visits. Maintains and reviews patient records, charts and other pertinent information.
  • Supervisory Responsibilities:
  • Functions as a clinical resource for the Clinical Care Managers and the Social Workers by assisting the team in problem solving, identifying resources to support patient care, and collaborating with practice staff, Practice Managers and/or Providers when necessary to resolve patient issues.
  • Oversees the daily work demands of the team to prioritize assignments and assure patient outreach requirements are maintained (runs reports, distributes work assignments for coverage, etc)
  • Supports the department in developing and maintaining best practices by assisting with staff audits and ongoing education. Provides feedback to improve processes or clinical practice.
  • Manages team schedules/timecards, participates in the recruitment and selection process, completes introductory and annual performance reviews, and manages performance of team members on an ongoing basis.
  • Oversees and participates in the orientation and onboarding of new staff with regard to clinical experiences and education.
  • Supports and engages in frequent communication within the team and department, across Penn Medicine entities, and with local external agencies in order to facilitate seamless processes for patient care coordination within their region.

Credentials:

  • RN or RN-NJ (Required)
  • Active PA or NJ RN license based on position location. Dual (NJ &PA) RN licensure required within 3 months of hire. required.

Education or Equivalent Experience:

  • Bachelor of Science Nursing (Required)
  • Nursing (BSN) 5+ years prior clinical experience. Some prior experience with crisis intervention and supporting patients with psychosocial barriers to health. 1+ years supervisory or management experience preferred.

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

   Current UPHS employees must apply HERE
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