At Affinity Health Group, we specialize in taking care of people: our members, our patients, and our employees. We offer competitive salaries and great benefits! Benefits include: Health, Dental, Life, Accidental Death and Dismemberment, Long Term Disability, Paid Time Off, and 401(k).
Affinity is currently looking for a Clinical Care Manager to work from 8:00AM – 5:00PM, Monday through Friday.
Job Summary: The Clinical Care Manager (“CCM”) provides care management, self-management support, care coordination, and linkage to community resources to further develop Patient-Centered Medical Home (“PCMH)” capabilities by evaluating the practice(s) high risk/high cost patients with complex medical and/or psychosocial needs in order to achieve and maintain optimal wellness state.
Essential Duties & Responsibilities:
• Identify, screen, and assess patients with complex medical and/or psychosocial needs to evaluate current health status, history of treatment, resource needs, and compliance
• Contact eligible AHG patients telephonically to engage participation in Affinity’s Care Management program
• Coordinate care with PCP, nurse practitioner, psychiatrist, therapist, home health provider, and involved community resources as needed
• Perform general case management and follow-up
• Monitor patients for compliance with medications and appointments; track frequency of hospitalizations and admissions to outpatient services
• Educate family and caregivers on disease process
• Participate in all enrollment activities
• Participate on the QI Committee
• Other duties as assigned
Knowledge, Skills, and Abilities:
• Current certification or license (MA, LPN, RN)
• Understanding of clinical program design, implementation, management, monitoring, and reporting
• Knowledge of NCQA standards and the accreditation process
• Knowledge of CPC+ program a plus
• Three years of general clinical experience required
• Experience treating patients with complex medical and/or psychosocial needs of all ages in addition to crisis intervention experience and case management and/or utilization review experience
• Vast knowledge of available community resources
• Exceptional interpersonal, verbal, and written communication skills
• Strong problem solving and analytical skills
• Microsoft Office Excel, Word, Outlook, and Powerpoint
• Ability to anticipate and constructively resolve barriers and constraints
• Ability to work with limited supervision; able to make educated decisions based on established policies and procedures
• Works under general supervision of the Integrated Care Management Manager
• Overtime will be occasionally required
• Travel will be required
• Will work in clinical setting to collaborate patient care with primary care provider and his/her healthcare team
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit, use hands and fingers, handle or feel, reach with hands and arms, and talk or hear. The employee is frequently required to stand and walk. The employee must regularly lift and/or move up to 20 pounds and frequently lift and/or move up to 50 pounds.
Licensed Practical Nurse
Registered Nurse Certified
Complex Problem Solving
Program Design Languages