Nurse Care Manager (69852)

DEFINITION:

Identify, screen, plan, track, and coordinate the integrated care of consumers with multiple co-morbidities including serious mental illness and addiction disorders.

SUPERVISION: Position is supervised by the program supervisor.

essential job functions include, but are not limited to:

• Works with consumers to assess their conditions and needs in order to develop and supervise personalized care plans.
• Provides comprehensive nursing assessment to gather all pertinent physical and behavioral health information.
• Advocates for consumers and their families linking them to other members of the care team to help them gain knowledge of their disease process and to identify community resources for continued growth toward the maximum level of independence.
• Utilizes motivational interviewing skills to empower consumers with improving their overall health and wellness.
• Assists consumers in recognizing and utilizing their own strengths, skills, and abilities in reaching their goals.
• Provides linkage and advocacy for services and information such as smoking cessation, nutrition, exercise, stress management, and chronic disease management.
• Actively participates in the development of a coordinated and comprehensive plan of care addressing the physical, behavioral, and psychosocial needs of each consumer.
• Leads interdisciplinary treatment team meetings to review clinical assessments, update care plans and determine follow-up frequency with the team.
• Must be knowledgeable of community resources and maintain positive working relationships with primary care providers and social service agencies. Must also work closely with community partners to obtain resources and collaborate on needs.
• Complies with all agency policies and procedures, including but not limited to documentation deadlines and productivity expectations.
• Performs any reasonable work requested that falls within the qualifications but not specifically described in work performed.
• Maintains consistent work attendance and contact supervisor on timely basis for needed late arrivals or absences