RN Care Manager
As a member of the Medical Services Team’s Health Home program, provides care coordination for clients with substance use disorder (SUD), Severe and Persistent Mental Illness, Intellectual Disabilities, and complex chronical medical conditions, in the office and community setting, under minimal supervision. All Health Home team members are responsible for providing outreach and client engagement services, after care and discharge planning, and care coordination for clients enrolled in the program(s). The health home Nurse serves in an expanded role to collaborate with members of the client’s care team including: PCP (Primary Care Provider), specialists, pharmacy, other community agencies and other services providers within CWN (Centra Wellness Network), and patients/families to ensure the delivery of quality services specific to client need. Assesses plan, implements, coordinates, monitors, and evaluates all options and services with the goal of optimizing treatment needs and client’s health status. Integrates evidence-based clinical guidelines, preventive guidelines, and protocols, in the development of individualized care plans that are patient-centric, use of evidence-based practices in treatment of SUD and behavioral health issues along with promoting quality and efficiency in the delivery of health care. The employee will complete other tasks as needed in various programs as assigned by the supervisor.
CWN recognizes all person’s vulnerabilities to trauma, and traumatic experiences and that impact on daily living. It is our practice to use practice models suitable to our job that are evidence based or sound practices that support our daily functions, models of treatment, and strength-based initiatives and outcomes. As a member of the CWN team staff will provide support throughout the agency, develop leadership skills, complete their tasks with efficiency and effectiveness and accept that all practices adhere to a recovery-based practice, providing the supports and guidance to empower, and promote recovery in clients and peers. CWN strives for collaborative relationships within the community, working with others in a professional, respectful, and positive manner that enhances a culture of creativity and support.
Knowledge, Education and Training (licenses, programs, or certificates):
· Must have current Michigan Registered Nurse, Nurse Practitioner, or Physician Assistant license.
· Knowledge of chronic physical and mental conditions and substance use disorder, evidence-based guidelines, prevention, wellness, health risk assessment, and patient education required.
· Training and education in Substance Use Disorders, Behavioral Health and Co-occurring disorders.
· Training and/or knowledge of the impact of SUD and mental illness on physical health.
· Experience in motivational interviewing and skills for client engagement along with other interventions, screenings and treatments used in behavioral health and substance use disorders, including understanding of Stages of Change by Sharon Melnick, MD.
· Knowledge of Excel spreadsheet and other standard office software.
Experience: At least one-year experience working in the mental health and/or SUD field and experience in providing care management in a community setting preferred. Minimum of two years of progressively more responsible or expansive experience working in primary care/ambulatory care, SUD and/or mental health, home health agency, skilled nursing facility, or hospital medical-surgical setting, within the past five years required. Lived experiences with mental illness, developmental disabilities, and/or substance use disorders valued.
