RN Care Manager - Shawano​/Gillett​/Suring​/Mountain - Green Bay, WI

RN Care Manager – Shawano / Gillett / Suring / Mountain – Green Bay, Wisconsin

Job : #25-510

Location:

Green Bay, Wisconsin, United States. Position Located In Shawano, WI.

Responsible for coordinating the continuum of care for assigned patients and ensuring optimum utilization of resources, excellent service delivery and positive quality outcomes, while minimizing unnecessary medical expenses.

• Implement evidence-based treatment guidelines for clinically diagnosed conditions.
• Prepare chart for assigned patients prior to appointment.
• Follow protocols for standing orders for medication refills, ordering tests and delivery of routine preventative services.
• Educate patients and families about managing their condition and/or disease.
• Conduct previsit planning with providers.
• Write individual care plan with treatment goals.
• Assess patient barriers to outcomes as it relates to medication, appointments and goals.
• Coordinate visits with multiple clinicians and/or diagnostic tests during one visit.
• Determine through triage how soon patients need to be seen.
• Provide telephonic advice on clinic issues.
• Identify health insurance or financial resources for patients.
• Systematically send or communicate medical information to patients.
• Review clinical measurements with patients at visits.
• Review information from facilities (discharge summary, hospital admission or ER visits) to determine if patients require a follow-up visit or are at risk for adverse outcomes.
• Contact patients after discharge from facilities.
• Provide or coordinate follow up care to patients/families who have been discharged.
• Develop written transition plan in collaboration with family and patients when transitioning to another facility or provider.
• Aid in identifying a new primary care physician or specialist or consultant and offer ongoing consultation.

• 3-5 years in a clinic setting (Required).
• Experience in specialty or primary care with EMR experience (Preferred).

• Excellent assessment skills.
• Excellent communication, written and analytical skills.

• Current license as Registered Nurse in the state of Wisconsin (Required). Upon Hire.

Not specified.

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