Geriatrics RN Care Mgr MHCP - Job at MedStar Health in Baltimore, MD

Geriatrics RN Care Mgr MHCP

Baltimore, MD

Posted 12 days ago

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Job Description

General Summary of Position
The Geriatrics RN Care Manager is responsible for the coordination and delivery of patient care related to Complex Home Bound older adults in the MedStar Health Geriatrics. The Geriatrics RN Care Manager works with limited guidance in the coordination of care directed by the licensed independent providers of the HBPC team. The Geriatrics RN Care Manager is also responsible for monitoring critical systems reporting and following up after acute hospital utilization events, and coordinating appropriate care, post utilization event in coordination with the interdisciplinary team. The Geriatrics RN Care Manager has primary responsibility for monitoring key quality measures for the practice identified by the practice leadership and in concert with identified alternative pay model programs. As directed by independent licensed providers, the Geriatrics RN Care Manager may also perform routine direct patient care appropriate to the identified scope of practice, within the patient's place of residence.

Primary Duties and Responsibilities

Conducts functional assessment by phone to screen new patient eligibility for MedStar House Call Program. Once approved for the program, provides education to patient, family, and care members to discuss goals of care as determined by the providers.

Conducts appropriate patient education either by phone or in person, in accordance with the care plan developed as part of the interdisciplinary team. Conducts appropriate post utilization event follow-ups, care coordination and patient education.

Reviews all patient intake documentation for completion, confirms information as appropriate and ensures all documentation is appropriately uploaded in the electronic Health Record.

Monitors and reports on identified organizational quality measures to include reporting to external agencies as required for participation within identified special programs or reporting. Ensures that quality measure performance data is routinely reported to assigned practice providers to facilitate improvements in the quality of care. Monitors patient census for department for utilization events using multiple electronic health record systems.

Contributes to the achievement of established department goals and objectives and adheres to company and department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulation.

Performs routine direct patient care of home bound patients within the RN scope of practice to include but not limited to collection of patient testing specimens (blood, urine, or other), provision of routine vaccinations (Flu, COVID, others as directed).

Leads the weekly MHCP meeting. Reviews high risk patients for appropriate care; may require use of various telehealth tools.

Triages all clinical calls routed from the MHCP Care Coordinators. Assesses and determines urgency of request before routing to appropriate clinician

Orders medical and office supplies by contacting approved vendors to maintain appropriate inventory levels.

Oversees and reports on skilled care coordination of patients in conjunction with MHCP Care Coordinators

Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings, serves on committees and represents the department and hospital/facility in community outreach efforts as appropriate

Coordinates with external agencies for the provision of routine Medical DME and other community assistance for home bound older adults assigned to the program.

Minimum Qualifications
Education

Bachelor's degree from an accredited School of Nursing required

Experience

1-2 years 2 years of experience as a nurse required and
1-2 years Geriatric experience preferred

Licenses and Certifications

RN - Registered Nurse - State Licensure and/or Compact State Licensure Valid RN license Upon Hire required

Knowledge, Skills, and Abilities

Exceptional organizational, problem-solving and time management skills.
Working knowledge of regulatory guidelines and accreditation standards.
Ability to use a computer and other software tools for population health management and completion of clinical documentation.
Ability to work independently and as part of a team.
Strong interpersonal skills both in person and over the phone, including verbal and written communication.

Why MedStar Health?
At MedStar Health, we understand that our ability to treat others well begins with how we treat each other. We work hard to foster an inclusive and positive environment where our associates feel valued, connected, and empowered. We live up to this promise through:

Strong emphasis on teamwork - our associates feel connected to each other and our mission as an organization. In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.
Strategic focus on equity, inclusion, & diversity - we are committed to equity for all people and communities. We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.
Comprehensive total rewards package - including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
More career opportunities closer to home - as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.

About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.

MedStar Health is an Equal Opportunity (EO) Employer and assures equal opportunity for all applicants and employees. We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations. MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws. If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.

Job Summary

Company

MedStar Health

Start Date

As soon as possible

Employment Term and Type

Regular, Full Time

Required Education

Bachelor's Degree

Required Experience

1 to 2 years