AHP Care Manager | Rochester, NY - Job.com

AHP Care Manager

for University of Rochester in Rochester, NY

Job Description

Opening

Full Time 40 hours Grade 044 URMC Accountable Care Network

Responsibilities

**General Purpose:**

The AHP Care Manager works collaboratively with interdisciplinary practice teams to manage clinical aspects of the patient-centered medical home and improve the health of the AHP population.

**Specific Responsibilities:**

With the direction of AHPs Director of Care Management and in collaboration with primary care practice site Medical Director(s), the care manager works with practice staff to support high quality, cost-effective patient-centered care consistent with NCQA recognition standards for patient-centered medical homes including proactive patient management, care coordination and transition management, and treatment planning functions:

In collaboration with practice staff, the AHP care manager:

* Assists practices in meeting quality measures as defined by AHPs shared savings contracts
* Reviews patient dashboard details to support up to date laboratory, preventive tests, and follow-up office visits
* Identifies/prioritizes improvement opportunities and facilitates activities to promote access and continuity of care as well as to close gaps in medical care and optimize performance on targeted metrics
* Designs and supports implementation of quality improvement interventions appropriate to practice needs/goals including monitoring effectiveness through data collection and analysis; develops barrier reduction strategies and provides feedback to practices as appropriate
* Assists in the development of evidence-based protocols, policies, work flow/flow sheets, guidelines, etc. related to the provision of care within the patient-centered medical home
* Participates in chronic disease management program development
* Coordinates medical care of patients identified as high risk of adverse outcomes by health assessment/physician determination; assists in developing and implementing care plans for medically complex patients
* Develops and supports implementation of comprehensive transitional care plans with emphasis on coordination of care and services post-critical events (e. g. ED, hospital, or SNF admission/discharge)
* Coordinates use of clinical and ancillary resources within and outside of the health system to achieve treatment goals specified in patient care plans
* Submits required reports in timely manner

Strong commitment to continuing education and professional development

Adherence to infection control/safety guidelines

Adherence to Health Insurance Portability & Accountability Act (HIPAA), The Joint Commission (TJC), and Occupational Safety & Health Administration (OSHA) regulations and policies

**Position requirements:**

RN with current NYS license required; Associates degree (prefer baccalaureate degree) and 5 years of clinical nursing experience preferred; experience in ambulatory care and/or community health desirable as is care management, quality improvement and/or management experience

Excellent communication skills including ability to form strong collaborative interdisciplinary partnerships across care settings

Sound computer knowledge and skills including an aptitude for using state of the science health information technology to guide care management activities and functions

Ability to work independently and meet deadlines

Creativity and strong organizational skills

Valid NYS drivers license including access to reliable transportation that enables fulfillment of positions travel requirements

*EOE Minorities/Females/Protected Veterans/Disabled*

*Job Title:* AHP Care Manager

*Location:* Medical Faculty Group

*Job ID:* 186758

*Regular/Temporary:* Regular

*Full/Part Time:* Full-Time

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