Care Management Coordinator
: Job Details :

OverviewWestern Michigan University Homer Stryker, MD, School of Medicine is hiring for a Care Management Coordinator. Facilitates a shared goal model within and across care settings to achieve high-quality managed care that is patient- and family-centered. Manages team-based care to provide health services to individuals, through effective partnerships with patients, their caregivers/families, community resources, and their physician. Uses a standardized process and decision support tools to identify patients needing care management assistance, including those with defined chronic illnesses and those experiencing transitions of care. Assesses patient needs and partners with patients to develop self-management goals and an associated plan of care with targeted interventions. Works collaboratively with physicians and other healthcare workers to provide appropriate follow up and to assist with patient education. Determines when patients are able to be discharged from care management.Responsibilities* Utilize clinical decision support tools to assess patient and family's health literacy, unmet health needs, and social determinants of health to support a guided care process in collaboration with patients/family toward an effective plan of care.* Develop, educate, and document patient self-management goals and care plan in partnership with patients and families.* Assist in identification of gaps in services related to the plan of care and facilitates completion of recommendations to close the gaps.* Following hospital discharge, engage patients in individualized transition of care planning.* Provide or facilitate access to care for a panel of patients.* Serve as an informational resource for patients and their family and facilitate care across the care team, payers, and community resources.* Actively participate in Care Manager-related training and meeting activities.* Assess readiness for discharge from care management and identify resources needed for successful transition after discharge.* Availability to work occasional overtime on weekends or evenings to complete time sensitive projects.* Acquires knowledge for new technology and policy/procedure revisions.* All other duties as assigned.QualificationsEDUCATION AND/OR EXPERIENCE:* Five years of experience in an ambulatory healthcare setting; primary care medical office experience preferred.* Previous experience in caring for chronic disease patients preferred.* Previous Care Coordination, Case Management or Home Health experience preferred.* Experience with navigation of local medical and social support systems preferred.LICENSES, REGISTRATIONS, CERTIFICATIONS:* Current Michigan RN license, BSN preferred.* BLS certification.OTHER SKILLS AND ABILITIES:* Knowledge of community health services.* Strong organizational skills and demonstrates the ability to maintain accurate notes and records.* Strong interpersonal skills.* Ability to demonstrate strong essential leadership, communication, education and collaboration and counseling skills.* Ability to communicate proficiently through technology (email, cell phone, etc.).* Ability to identify and implement appropriate patient communication strategies and overcome accessibility barriers, as required.* Ability to demonstrate continual learning skills, effecting changes in approach to care based on established, evidence- based practice.* Ability to determine appropriate course of action in more complex situations.* Ability to work independently, exercise creativity, be attentive to detail and maintain a positive attitude.* Ability to manage multiple and simultaneous responsibilities and to prioritize scheduling of work.* Ability to maintain confidentiality of all medical, financial and legal information.* Ability to complete work assignments accurately and in a timely manner.* Ability to communicate effectively, both orally and in writing.* Ability to handle difficult situations involving patients, physicians, or others in a professional manner.* Demonstrates the ability to recognize priorities in organization of work flow.* Able to perform duties independently, with a minimal need for direct supervision.About Western Michigan University Homer Stryker M.D. School of Medicine (WMed)We are committed to excellence and health equity through transformative medical education, high-quality, patient- and family-entered care, innovative research, and community partnerships within a just culture of diversity, equity, inclusion, and belonging. Our vision is health equity for all in Southwest Michigan through innovation in the practice and study of medicine.The medical school is a collaboration of Western Michigan University and Kalamazoo's two teaching health systems, Ascension Borgess and Bronson Healthcare. The medical school is a private nonprofit corporation supported by private gifts, clinical revenues, research activities, tuition, and endowment income. WMed is the recipient of a $100 million foundational gift and the Empowering Futures Gift, a philanthropic commitment of $300 million to support the mission of the medical school. WMed contributes to the economic vitality of Southwest Michigan through the services we provide as well as the creation of 1,600 new jobs and an annual estimated economic impact of $353 million in Kalamazoo and Calhoun counties.WMed is fully accredited by the Liaison Committee on Medical Education and the Higher Learning Commission. The medical school offers a comprehensive, innovative four-year Doctor of Medicine degree program and a Master of Science degree program in Biomedical Sciences. We train physicians in 10 residencies and five fellowships accredited by the Accreditation Council for Graduate Medical Education. To support our educational mission, we have Joint Accreditation for interprofessional continuing education, which incorporates accreditation by the Accreditation Council for Continuing Medical Education.WMed Health is the clinical practice of the medical school with more than 300 providers offering comprehensive primary care and specialty services in several locations throughout the Kalamazoo and Battle Creek areas. Faculty in the Department of Pathology serve as the Office of the Medical Examiner for counties throughout Michigan and northern Indiana.The W.E. Upjohn M.D. Campus located in downtown Kalamazoo serves as the primary educational facility with student study and social spaces, team-based learning halls, faculty and administrative offices, a state-of-the-art Simulation Center accredited by the Society for Simulation in Healthcare, basic science research labs, as well as toxicology and forensic pathology labs.WMed builds upon Kalamazoo's century-long foundation of drug discovery and medical device development with a strategic investment in clinical, laboratory, community, and educational research. The Center for Immunobiology, Center for Clinical Research, Research Histology Lab, Innovation Center, and Human Research Protection Program contribute to the medical school's advancement of knowledge through innovation and discovery.Western Michigan University Homer Stryker M.D. School of Medicine is an Equal Employment Opportunity/Affirmative Action employer of females, minorities, individuals with disabilities, and protected veterans, and actively strives to increase diversity within its community. We provide a drug- and tobacco-free workplace.EEO Minorities/Women/Disabled/Protected Veterans.