RN Care Manager (Dodge) (Home Based with Field Travel)
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This is a float position primarily within Dodge County, potential travel up to 2 hours within the service region.
The RN Care Manager, as part of an interdisciplinary team (IDT), serves frail elders, adults with physical disabilities and adults with intellectual/developmental disabilities who are members of Lakeland Care, Inc. (LCI). The team’s goal is to promote the overall well-being of the members LCI serves by providing high quality, person-centered, outcome-based care.
Under general direction of the Care Management Supervisor, this position provides care management and service coordination to LCI members. As a member of the IDT, the RN Care Manager (RNCM) arranges for provision of services and supports based on a comprehensive assessment of the member's identified outcomes and needs. The IDT staff monitors the provision of services based on the member-centered plan per LCI policy and procedures, and Department of Health Services (DHS) contract requirements.
Essential Competencies:
- As part of an interdisciplinary team (which also includes a care manager and the member and/or legal representative), the RNCM conducts a comprehensive assessment of the member's outcomes, needs and risks; and reassesses as the member’s outcomes and/or condition changes.
- Coordinate acute and primary care services, care transitions and related follow-up care.
- Develop, coordinate, monitor, and evaluate members’ outcome-based member-centered plans, considering cost and effectiveness in authorizing services and choosing providers.
- Promote prevention and wellness by incorporating preventative, supportive, restorative, and rehabilitative care into the care planning process.
- In collaboration with the Care Manager (CM), implement risk mitigation strategies to promote the member’s health, safety and independence while respecting the member’s rights.
- Participate in on-going training to maintain current knowledge to ensure compliance with Federal and State regulations, LCI policy and procedure and accepted professional standards.
- Create and maintain member records as required by the Department of Health Services (DHS) contract and LCI policy.
- Participate in, via face-to-face, in-home visits and care conferences involving the member, their supports, and providers to assess, reassess, and address health and medically related needs.
- Participate in the 24-hour on-call rotation as necessary.
- Participate in team meetings and internal workgroups as required/requested.
- Provide nursing care in accordance with the Nurse Practice Act.
- Maintain the confidentiality of member information and protected health information (PHI) as required by State and Federal regulations, including the Health Insurance Portability and Accountability Act (HIPAA) of 1996.