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Job Description
Job Summary
Plans and prioritizes care for individuals and population of patients, focusing on strategies that will promote optimal health within populations. Demonstrates expertise, current knowledge in nursing care and management of a caseload of patients of varying complexity and seeks to improve patient, family and health systems / community outcomes through the application of educational concepts / skills and preventive care in a managed care environment.
Essential Functions
Assesses internal and external referrals to identify patient/significant others' needs, level of intensity, insurance benefits and other patient resources.
Develops plan of care and makes recommendations to PCPs, specialists and other members of the health care team regarding care management strategies, identifying strategies to maximize continuity of care across the continuum.
Assesses the educational needs of patients, families and members of the health care team and develops and implements appropriate teaching strategies or makes appropriate referrals.
Communicates and collaborates with patient/significant others/providers/payers to coordinate services that improve access to appropriate services across the continuum of care and which promotes optimal health in a cost-effective manner.
Measures patient care outcomes, interprets reports and analyzes data trends for groups of patients.
Documents patient data, plan, interventions and outcomes according to department guidelines.
BSN preferred
Certification (CDCES, ACE, CCM, etc) preferred
Qualifications
Required Bachelor's Degree or equivalent nursing or a healthcare related field (all departments except Spectrum Health Ludington)BSN must be obtained within 7 years for those who start in this RN role on or after January 1, 2017 (Spectrum Health Ludington Hospital)
5 years of relevant experience clinical nursing and or case management/managed care or related field Required
LIC-Registered Nurse (RN) - STATE_MI State of Michigan
CRT-Basic Life Support (BLS) - AHA American Heart Association
CRT-Basic Life Support (BLS) - ARC American Red Cross
CRT-Case Manager, Certified (CCM) - CCMC Commission for Case Manager Certification
Primary Location
SITE - Priority Health - 1231 E Beltline - Grand Rapids
Department Name
PH - Care Management - Commercial
Employment Type
Full time
Shift
Day (United States of America)
Weekly Scheduled Hours
40
Hours of Work
8:00 a.m. - 5:00 p.m.
Days Worked
Monday - Friday
Weekend Frequency
N/A
Spectrum Health requires all team members to receive the COVID-19 vaccinations subject to certain exclusions based on the team member's job category. Spectrum Health is committed to granting reasonable accommodations in accordance with applicable laws.
Accommodation Notice: If you are a qualified individual with a disability, you may request a reasonable accommodation in Spectrum Health's application process. Contact us at 616-486-SHHR (7447).
Spectrum Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, sexual orientation, veteran status, or any other legally protected
category. See more here (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf) .
Spectrum Health requires all team members to receive the COVID-19 vaccinations subject to certain exclusions based on the team member's job category. Spectrum Health is committed to granting reasonable accommodations in accordance with applicable laws.
Who We Are
Spectrum Health is a nationally recognized not-for-profit health system, offering a full continuum of health services through our health plan, medical group and hospital group. As an integrated health system, we are able to work together across all facilities, employees and providers to create exceptional, consumer-focused interactions.
Spectrum Health is redefining what it takes to improve the health of our communities and introducing new and innovative ways for consumers to access high-quality, low-cost care so that they can connect with us for a lifetime of health.
We strive to provide one Spectrum Health experience: a consistent, high-quality, seamless health journey for consumers; no matter where, when or how they interact with us. The result is better health outcomes for the thousands of individuals, families and communities we serve.
We are the region's largest employer, with corporate offices located in Grand Rapids, Michigan. Spectrum Health Hospital Group and Spectrum Health Medical Group are consistently recognized for the exceptional care they provide. Priority Health is among the largest health system-sponsored health plans in the U.S. and offers extensive experience serving large and small employer groups, individuals, Medicare Advantage, Healthy Michigan Plan and Medicaid populations.
Since 2010, Spectrum Health has been listed five times among the 15 Top Health Systems in the U.S. by Truven Analytics™. Click here (https://www.spectrumhealth.org/about-us/quality-safety-and-patient-experience/awards) to see a complete list of our safety, quality and patient experience awards.