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RN Care Manager Population HealthJob ID 147829 Date posted 07/24/2018
The Behavioral Health Community Partner (BHCP) program at Lahey Health Behavioral Services is a new, innovative Care Management program for MassHealth members that are part of the new Accountable Care Organization (ACO) and or a Managed Care Organization (MCO). The RN Care Manager provides medical reconciliation, high quality integrated care, clinical assessment, is a Member of a multi-disciplinary team that support BHCP enrollees treatment plan.
Provides leadership and responsible for developing, training, managing and supervising a team of Clinical Care managers, care coordinators and peer specialists.
Ensure adherence to BHCP performance specification and support BHCP Director in the implementation and coordination of BHCP performance specification requirements, policies and procedures, training care transitions and other activities
Perform medication reconciliation following inpatient stay within 3 days of discharge. Activities of medication reconciliation include but may not be limited to: Contacting the Engaged Enrollee's PCP to verify that medication orders from discharge are appropriate;
1. Verifying that medication orders are filled accurately;
2. Ensuring that the Engaged Enrollee demonstrates understanding of medication administration;
3. Checking for any discrepancies and issues of medication non-compliance, particularly in cases of multiple prescribers;
4. Supporting the Engaged Enrollee?s adherence to medication regimen;
5. Identifying supports that are available or could be made available to support the Engaged Enrollee in medication administration; and
6. For Engaged Enrollees participating in a Medication Assistance Program (MAP), sharing updated medication order forms from the Engaged Enrollee?s PCP or discharging prescriber with the MAP provider.
Review enrollee comprehensive assessments including medical history, medical needs, medication and functional status.
Collaborate with the BHCP care team to ensure that assigned enrollee?s behavioral and physical care needs are met and coordinated across all continuum care.
In collaboration with the care team identify supports that are available or could be made available to support enrollee's in medication administration and compliance.
Provide health education, coaching and symptom management to enable enrollee to managed their chronic conditions
Participates in training, clinical rounds, quality meeting, treatment team meetings and other meetings as needed.
Knowledge of and ability to work effectively with community based resources, referral networks, and public/private systems of care
Perform other duties as needed to support BHCP program requirement.
Carries out supervisory responsibilities in accordance with the Lahey policies and procedures and applicable laws. Responsibilities include supporting the BHCP Director with interviewing, hiring and training employees; performance management; addressing complaints and resolving problems.
The position does not have direct budgetary management; however in conjunction with the BHCP Director should have awareness of fiscal requirements and be able to disseminate accurate financial information to when appropriate.
Utilizes active listening and gets clarification when needed; responds appropriately to questions. Writes clearly and informatively. Responds to common inquiries and complaints from clients, regulatory agencies, and other service providers. Defines problems, collects data, establishes facts and draws valid conclusions.
Registered Nurse with experience in the field of mental health and/or substance abuse.
Current Massachusetts RN license, BLS, and minimum of 2yrs experience preferably with Behavioral health
Strong clinical management or leadership experience
Proficiency with electronic health record documentation or ability to complete documentation electronically is required. Working knowledge of windows operating system and standard desktop applications such as Windows and Microsoft Suite.
Ability to handle multiple priorities.
Ability and desire work with a diverse client population. Ability to manage difficult or emotional situations; respond promptly to enrollee's needs. Focus on solving conflict.
40 hours, full time
While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel; reach with hands and arms; climb or balance; stoop, kneel, crouch, or crawl; and talk or hear. The employee frequently is required to walk. The employee is occasionally required to stand and sit. The employee must frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.