Population Health Care Manager- Rising Risk

Overview

Join to apply for the Population Health Care Manager
- Rising Risk role at Duke University Health System
.

• Coordinate and facilitate timely implementation of assessments, care plans, and appropriate interventions for identified patient populations to determine health, social situation, physical environment, mental health, substance use, expressed trauma, economic status, and education to patients while exercising discretion and independent judgment; following established policies and procedures.
• Provide individual treatment to address barriers and identified concerns by accessing data from multiple sources such as patient medical records, claims, and program metric reports to target recipients and providers for outreach, education, and intervention.
• Perform targeted interventions to assist patients with connection to primary care providers and other health care resources. Involve the patient and their support systems in the decision-making process.
• Use a patient-centric, collaborative partnership approach to assist the patient with improved self-management and identifying barriers by addressing the total individual, inclusive of medical, psychosocial, behavioral, and spiritual needs.
• Utilize processes to measure a patient's understanding and acceptance of the proposed plan(s), willingness to change, and support to maintain health behavior change.
• Apply teaching and learning theories to assist patients and families with physical and emotional impact of body changes and chronic illness.
• Monitor quality and effectiveness of interventions for the population by setting long-term and/or short-term specific, measurable goals.
• Electronically document all activity in Maestro and other documentation systems relevant to the position.
• Communicate and coordinate with all providers and care team members as needed to minimize fragmented care and foster appropriate utilization of services, including transitions of care from hospital to home or community facilities.
• Facilitate interdisciplinary communication to include specialists, PCP, RN, psychiatrist, and other key providers.
• Interface with key providers within hospital and community networks to link patients to and engage in services.
• Provide on-site, community, and telephonic outreach to patients, providers, and community stakeholders to identify treatment history, diagnoses, and care components while considering ethnic and cultural backgrounds.
• This position may require home visits based on business rules and clinical need.
• Provide feedback to leadership that will enhance negotiations with payers, improve care management, and address gaps in care.
• Develop and maintain positive relationships with customers internal and external to Duke Health System.

Education

Bachelor’s degree in a clinical field such as Nursing, Counseling, Social Work, Therapy, Allied Health, or community health related fields.

Experience

3 years of clinical experience required.

Degrees, Licensures, Certifications

Must have a current license in at least one of these areas:

• Current or compact RN licensure in the state of North Carolina
• Current licensure as a licensed clinical social worker by the NC Social Work Certification and Licensure Board
• Current licensure as a Licensed Professional Counselor by the state of NC
• Current licensure as a Licensed Addiction Specialist by the state of North Carolina
• Requires ACM or CCM certification within 3 years of hire date.

Equal Opportunity

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual’s age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.

Essential Physical Job Functions

Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

Senior Consultant
- Health Care & Biotech

Population Health Care Manager
- Rising Risk

Population Health Care Manager
- QuEST Team

Population Health Care Manager
- Complex Care Management

Population Health Care Manager (BSN Highly Preferred)

Manager-Quality Performance (Full Time, Remote, North Carolina Based)

Clinical Instructor (Health Administration)

Population Health Care Manager (BSN Highly Preferred)

Healthcare Clinical Documentation Specialist

Clinical Consultant, Planning and Analytics for Total Health

Regional Service Manager - Cleveland, OH

Cary, NC $-$ 4 months ago

Durham, NC $50,000.00-$53,000.00 2 months ago

Service Operations Manager - South GA/North FL

Cary, NC $-$ 4 hours ago

Durham, NC $95,000.00-$ 6 days ago

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.