Clinical Case Manager

GMP Network - Clinton Township, MI (30+ days ago)


GMP Network is seeking an RN or LMSW case manager with at minimum of 5 years experience preferable 2 years in ambulatory care. The successful candidate will have experience working with primary care physicians and have a working knowledge of case management principles. Familiarity with BCBSM Provider Delivered Care Management (PDCM), and High Intensity Care Management (HICM) programs a plus.

Responsibilities include; identifying and providing case management services to GMP Network clients, working collaboratively with the GMPN clinical integration team, physicians, and their staff to help coordinate care, ensuring effective and efficient delivery of services resulting in improved patient outcomes, and reducing health care costs.

Essential Function(s) of the Position:

  • Assist with identification of clients eligible for care management services.
  • Work with Provider and office staff to facilitate optimal patient care.
  • Educate physicians and office staff regarding patient care management process and care plan implementation.
  • In depth knowledge of available resources, contacts and social services.
  • Review patient needs to assure care team is meeting medical, behavioral, and social needs
  • Ensure that patients receive proper care in the most suitable setting by appropriate providers.
  • Link patients to community services and support professionals as appropriate.
  • Assist with medication reconciliation.
  • Work with patients and their families to identify and remove barriers to health care.
  • Provide information, reinforcement, encouragement, reminders, and follow-up to support members in achievement of their care plan goals.

Education/Experience

Masters in Social Work, Registered Nurse, or Behavioral health specialist with at least two years experience in primary care office setting.

Licensing/Certifications:

Valid Michigan Driver’s License, and Professional clinical license required. RN, BSN, or LMSW required.

Knowledge, Skills and Abilities:

  • Understanding of case management process including transition of care, home healthcare, ambulatory care, outreach, disease management, family dynamics.
  • Experience in providing outreach, disease management, and/or self-management services to families.
  • Knowledge of quality metrics for chronic conditions and preventive services.
  • Ability to work with metrics to measure outcomes
  • Completion of a BCBSM authorized care management program a plus
  • Ability to work with physicians and other health care professionals.
  • Understanding of diverse populations and utilization patterns.
  • Demonstrated excellent interpersonal communication and presentation skills.
  • Ability to work with patient family or other caregiver and, in conjunction with the physician office. provide direction and education regarding care plan.

Reporting Relationships:

Position reports to the Director of Clinical Integration.

Job Type: Full-time

Experience:

  • case management: 5 years (Required)

License:

  • LMSW: RN, (Required)

Work authorization:

  • United States (Required)