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Henry Ford Health System Embedded Case Manager (Registered Nurse / RN) - Health Alliance Plan / onsite at Henry Ford West Bloomfield Hospital in Detroit, Michigan

GENERAL SUMMARY:

Under minimal supervision, facilitates the care of HAP members in the inpatient care setting to ensure quality outcomes and appropriate utilization of health care resources. The case manager works in collaboration with a multidisciplinary team in planning, implementing and evaluating medical and nursing services. Responsible for the case management activities of high risk members transitioning to the outpatient setting. Provides bio/psycho/social assessments, develops an individualized care plan, implements case management interventions, coordinates care, monitors outcomes and evaluates the delivery of quality, cost effective health care services across the continuum of care.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

  • Conducts a comprehensive assessment of member and family/caregiver’s psychosocial functioning and needs as they relate to acute and chronic illness.

  • Participates in the development of a care plan with the multidisciplinary health care team, member and family/caregivers.

  • Identifies and plans strategies to reduce avoidable re-admissions and emergency room visits. Works in coordination with physicians, discharge planners and other health care providers. Arranges for supportive services such as physician office visits, physical therapy, occupational therapy, speech therapy, cardiac rehabilitation, pulmonary rehabilitation, etc. as needed

  • Provides education to improve health literacy and counseling to members and their family. Topics include, but not limited to: healthy lifestyles, preventative services, disease processes/clinical practice guidelines, and self-management strategies.

  • Engages members in goal setting and action planning to assist in achieving optimum levels of health.

  • Utilizes professional judgment and critical thinking in identifying and assisting members in overcoming barriers to goal achievement.

  • Advocates for the member and/or family throughout episodes of care

  • Works in collaboration with contracted facilities to facilitative effective communication among members of the multidisciplinary care team and to monitor progress.

  • Develops and maintains relationships with internal and external resources to ensure member needs are met.

  • Collaborates with management to design and establish program improvements.

  • Performs other duties as assigned.

EDUCATION/EXPERIENCE REQUIRED:

  • Associate’s degree in Nursing.

  • Three (3) years of relevant clinical nursing experience in medical inpatient, ambulatory setting, specialty care, discharge planning, home health care, community health, rehabilitative medicine or chronic disease health coaching.

  • Bachelor’s degree in related field, preferred.

  • Experience in patient care coordination, case management, managed care/health insurance, preferred.

  • Superior communication and conflict management skills allowing for the management of complex issues with effective diplomacy.

  • Excellent written and interpersonal communication skills.

  • Excellent documentation

  • Strong problem solving, analytical and decision making.

  • Strong organizational, planning and implementation.

  • Well-developed time management and prioritization.

  • Creative and resourceful.

  • Organizational skills required to manage priorities as dictated by business needs.

  • Ability to identify, assesses, and solve highly complex problems relating to team dynamics, benefits administration, and the delivery of health services.

  • Knowledge of clinical pharmacology and implications.

  • Understanding of community resources.

  • Knowledge of case management goals, strategies and measurement.

  • Medical management processes across the continuum of care.

  • Knowledge of medical ethics and legal implications of case management.

  • Understanding of the needs of diverse populations.

CERTIFICATIONS/LICENSURES REQUIRED:

  • Current Michigan Registered Nursing Licensure

  • CCM - Certification in Case Management, preferred.

  • ACM - Accredited Case Management, preferred.

  • CCP - Chronic Care Professionals Certification, preferred.

    Overview

    Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health

    care systems, is a national leader in clinical care, research and education. The system includes

    the 1,200-member Henry Ford Medical Group, five hospitals, Health Alliance Plan (a health

    insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory

    network and many other health-related entities throughout southeast Michigan, providing a

    full continuum of care. In 2015, Henry Ford provided $299 million in uncompensated care.

    The health system also is a major economic driver in Michigan and employs more than 24,600

    employees. Henry Ford is a 2011Malcolm Baldrige National Quality Award recipient. The

    health system is led by President and CEO Wright Lassiter III. To learn more, visitHenryFord.com.

    Benefits

    Whether it's offering a new medical option, helping you make healthier lifestyle choices or

    making the employee enrollment selection experience easier, it's all about choice. Henry

    Ford Health System has a new approach for its employee benefits program - My Choice

    Rewards. My Choice Rewards is a program as diverse as the people it serves. There are

    dozens of options for all of our employees including compensation, benefits, work/life balance

    and learning - options that enhance your career and add value to your personal life. As an

    employee you are provided access to Retirement Programs, an Employee Assistance Program

    (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness, and a whole host of other benefits and services. Employee's classified as contingent status are not eligible for benefits.

    Equal Employment Opportunity/Affirmative Action Employer

    Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.
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