Nurse Care Manager

The Nurse Care Manager leads the development and ongoing management of a comprehensive, individualized care plan with each consumer. The care plan helps the consumer, and their family fully understand their clinical condition, manage symptoms associated with their condition, understand and navigate treatment alternatives, and address non-clinical issues that impact quality of life and outcomes.

Definition

Under immediate to general supervision, provides case management, rehabilitation and wellness services to individuals and groups in various settings. This position is supervised by the respective Director of Integrated Care.

Job Duties and Responsibilities

• Provide varying types of individualized care management, nursing and wellness services in various settings to individuals, families and groups to promote emotional or psychological change to alleviate mental disorders and facilitate recovery.
• Monitor and evaluate the needs and abilities of the consumer and assist them to function more adequately through use of their own strengths and through use of community resources.
• Complete all agency documentation of services in a thorough, accurate and timely manner.
• Assist clients to adjust and adapt themselves to their environment, care and treatment.
• Assist in the development and implementation of Care Pathways.
• Serve as a role model for wellness behaviors.
• Apply the principles and processes of coaching when collaborating with others.
• Provide referrals to community resources for housing, employment, medical, nutrition education, weight management, Oklahoma Tobacco Helpline, and other community or wellness-related services and resources.
• Create partnerships within the local community to enhance consumer access to resources that support the individualized Care Plan goals.
• Maintain regular and predictable attendance.
• Perform all job related travel normally associated with this position.
• Meet agency standards of productivity and fiscal responsibility.
• Prepare for and actively participate in huddles, Care Planning and staff meetings.
• Meet satisfactory expectations at any scheduled job performance evaluation, coaching and/or Performance Improvement Plans.
• Complete Lighthouse required training and resulting follow up and consultation as required at hire, annually and as directed by Supervisor.
• Perform other reasonably related duties as assigned by the immediate supervisor or other management as requested.

Knowledge and Skills

• Ability to use clinical tools, data and other information to complete assessments of consumer needs and provide collaboration and input into the creation of individualized and comprehensive care plans.
• Knowledge of and ability to clearly explain the reason for prescribed treatments and treatment plans to patients.
• Communicate with patients, physicians and insurance companies to secure successful outcomes.
• Knowledge of and ability to follow case and quality management processes in compliance with regulatory guidelines and company procedures.
• Knowledge of the principles and practices of nursing and of current social and economic problems, principles of family economics and budgeting, human relations, community, state and national health and welfare resources, social assistance requirements, and psychological terminology.
• Knowledge of the elements of personal wellness and how to collaborate with others to identify their personal strengths and goals within the Eight Dimensions of Wellness.
• Able to work within an integrated team (inpatient and outpatient) to facilitate care by assessing consumer needs, evaluating treatment options, creating care plans, addressing treatment barriers, coordinating care with internal and external providers, and monitoring progress.
• Willingness to provide services within the community or consumer homes in order to promote engagement in the outpatient setting and assist in stabilization after a crisis or hospitalization.
• Ability to work effectively and courteously with people from various cultures and backgrounds, and to exercise good clinical judgment.