Case Manager

Maui Medical Group Wailuku, 2180 Main Street, Wailuku, Hawaii, United States of America Req #38
Monday, June 15, 2020

MAUI MEDICAL GROUP, INC.                                                                                 POSITION DESCRIPTION

Position Title

Department

CASE MANAGER

NURSING

INSTRUCTIONS:

In Section A briefly describe the overall purpose of this position.  Describe the position so that someone who does not know the position will understand it.  In Section B describe the specific tasks or duties.  The percentage of time spent performing the major job responsibilities is used for job evaluation purposes only.  In Section C list the minimum qualifications, type of equipment used (including the frequency), characteristics, and environmental factors relating to this position.

SECTION A: OVERALL PURPOSE OF THE POSITION

The Case Manager (CM), working with the patient’s PCP, ensures that patients receive appropriate, quality care that is cost effective. This includes screening, assessing and monitoring the needs of patients, determining treatment eligibility, using clinical options to decide if plans meet the patient’s needs, and making arrangements for additional services that help patient’s achieve a positive outcome and close gaps in the patient’s care.

SECTION B: MAJOR JOB RESPONSIBILITIES

*

PERCENTAGE

1.       Working with the patient’s PCP the CM contacts patients through appropriate methods and:

  • Develops an individualized care plan for each patient identified as high risk to meet the specific personal needs of patients.
  • Helps PCPs and/or their clinic staff manage high risk patients by providing PCPs with timely information on patient’s preventive screenings and their progress with the goal of reducing patient’s “gaps in care”
  • Helps patients with referrals for Behavioral Health, Healthcare Management, Tobacco Cessation, Substance Abuse counseling, etc. Tracks these patients to determine compliance and follow through with referrals.
  • Supports patient self-management of disease and behavior modification interventions and provides education to patients and their families about the proper way of following the health plans.

*

40

2.       Develops and presents educational updates, in-service and training for clinic/ department members, physicians and clinic staff using up to date resources

*

15

3.       Participates in Patient-Centered Medical Home (PCMH) team meetings and quality improvement initiatives. Participates with patient data collection, health outcomes reporting, clinical audits, and programmatic evaluation related initiatives.

*

15

4.       Knowledgeable with management and reporting tools (e.g. Cozeva, eCW’s CCM, CPC+ etc.) including educating PCPs and clinic staff on best use of these tools. Understands and uses utilization management reports to track gaps in care.

*

10

5.       Knowledgeable with Medicare’s chronic care guidelines and CPC+ Care Delivery Guidelines and understands the billing associated with these guidelines

*

10

6.       All other miscellaneous responsibilities and duties as assigned.

 

5.0

7.       Demonstrates quality work, completes assignments on a timely basis, and makes decisions within limits of authority. Takes initiative in problem solving, maintains confidentiality of patient and company information, and interacts with patients, co-workers, and management in a courteous and respectful manner.  Adheres to all company policies and procedures

 

2.5

8.       Maintains time and attendance standards consistent with company policy.

 

2.5

TOTAL:

 

100%

              Enter an asterisk (*) in this column to indicate Major Job Responsibilities that are essential functions

SECTION C: OTHER INFORMATION

 

 

RESPONSIBLE TO:

Director of Nursing

 

SUPERVISES:

N/A

 

MINIMUM QUALIFICATIONS:

Education/Experience:

Graduate from an accredited School of Nursing. Licensure as an RN in the State of Hawaii required. Active/unexpired CPR/BLS Card required.

 

Skills/Knowledge:

Self-disciplined, energetic, passionate, innovative. Highly organized and well-developed oral and written communication skills. Demonstrates sound judgment, decision-making and problem-solving skills.  Able to maintain confidentiality with all aspects of information in accordance with practice, State and Federal regulations.  Confidence to communicate and outreach to other community health care organizations and personnel

 

Desired/Preferred Qualifications:

 

Demonstrates effective communication and telephone skills. Proficient computer skills; including Microsoft Office (specifically Word and Excel, Cozeva, eCW, etc.)

 

Equipment Use:

Personal computer, telephone, and 10 key machine. Microsoft products, Internet and e-mail.

 

Characteristics:

Must be committed to the protection of confidential information, records, and/or reports. Must have the ability to communicate effectively in a professional and courteous manner. Must have good organizational skills and maintains a “can-do” attitude.

 

Environmental

Factors:

Requires prolonged sitting. Required some bending, stooping, and stretching for files and supplies. Requires manual dexterity sufficient to operate a keyboard and other office equipment. Vision must be correctable to 20/20 and hearing must be in the normal range for telephone contacts.

 

Other details

  • Pay Type Hourly
  • Maui Medical Group Wailuku, 2180 Main Street, Wailuku, Hawaii, United States of America