JOB SUMMARY

The primary role of the Managed Care Team Lead is to provide clinical expertise for specific complex and/or rising risk patient populations with a design to meet specific contractual and program related requirements. This role will perform disease management, assessment of disease, care plan development and facilitation, referral to appropriate levels of care, etc. The role functions as an integral part of an interdisciplinary team, ensuring excellence with transitions of care to achieve optimal clinical outcomes through a seamless model of access and care. Focus on improving the health status and care for individuals with chronic conditions with complex medical, mental health and psychosocial issues.  In collaboration with the care managers, the RN identifies plans and executes activities to promote effective care management and to ensure compliance according to policies and procedures. This position will serve as a resource and health educator for the patient.

MINIMUM QUALIFICATIONS

Education:  Current, Active, unrestricted Registered Nurse license in North Carolina

Experience: Experience in clinical or community resource settings; Care coordination and/or case management experience is preferred  Highly organized with ability to keep accurate notes and records • Experience with health IT systems and reports is desirable.

Skills: Must possess knowledge and skills necessary to treat patients.  Ability to manage care of patients remotely with staff from multiple health centers. May travel at times.  In additional to clinical knowledge, position requires strong organizational and interpersonal skills.

Type of Employees Supervised: None

Licensure, Registry or Certification Required: Active, unrestricted registered nurse license; Valid NC driver's license.

Immunizations:  Be medically cleared for communicable diseases and have all immunizations up-to-date prior to beginning employment.

PATIENT POPULATION SERVED

Medicare

PHYSICAL DEMANDS/ WORKING CONDITIONS

• Hearing: Adequate to perform job duties in person and over the telephone.
• Speaking: Must be able to communicate clearly to medical providers, patients and multiple personnel in person and over the telephone.
• Vision: Visual acuity adequate to perform job duties, including reading information from printed sources and computer screens. Must meet certification by colorblind standards.
• Other: Will be working with potentially hazardous chemicals, exposure to patient body fluids.
• Requires frequent lifting and carrying items weighing up to 40 pounds unassisted.  Requires frequent bending, reaching, and repetitive hand movements, standing, walking, squatting and sitting, with some heavy lifting, pushing and pulling exerted regularly throughout a regular work shift. Requires exposure to communicable diseases and/or bodily fluids.