NSPG Care Manager, Chronic Disease

 Lynn, , USA

 Part Time

Job Details

About Us

North Shore Physicians Group (NSPG), the largest multispecialty group north of Boston, has a singular focus: the patient. We are more than 320 physicians, nurses and health professionals working as one to provide exceptional care. And we are a national leader in improving care delivery, patient health and satisfaction.

Through our partnership with North Shore Medical Center and our affiliation with Massachusetts General Hospital and Partners HealthCare, we offer such advances as EMRs, shared medical appointments, online access and remote patient monitoring. Our success is built on team-based practices, collaborative environments and the importance of work-life balance. Bring your exceptional skills to our innovative practices and join us in driving medicine forward.
General Summary
We are seeking a Nurse Care Manager to support 10 of our Primary
Care Physicians.
The Care Manager serves as an integral member of the primary care team in the Patient Centered Medical Home model. As part of the physician-led Medical Home team, the Care Manager works closely and collegially with physicians, associate providers, clinical and administrative staff and collaborates to enhance the delivery of patient care services along the continuum of care.

The Care Manager will:

  • Follow a panel of primary care patients with chronic disease management needs who will be identified using new risk-stratification technology
  • Provide both episodic and ongoing education and coaching for chronic disease management using evidence based guidelines
  • Work closely and collaborative with other disciplines to enhance care coordination, including:
    • Behavioral Health
    • Social Work
    • Community Resource Specialists
  • Assist with patient care transitions, including:
    • Visits to specialists
    • Visits to the Emergency Department or Urgent Care
    • Admissions to inpatient and extended care facilities
    • Transitions to different models of care, such as long-term care or hospice.
The Care Manager will also serve as a resource to clinical services through mentoring and assisting with quality initiatives. Through broad knowledge of clinical care and systems management, the Care Manager will meet the patients' needs efficiently and expeditiously by continuously working to improve the patient experience, ensure high quality patient care, and reduce cost.


Experience

  • Required: Minimum of 3 years nursing experience.
  • Preferred: Primary care, home health, extended care, case management or care coordination experience.

Education

  • Required: Completion of an accredited Nursing degree program
  • Preferred: Bachelor of Science in Nursing (BSN) strongly preferred.

Licensure, Certifications, or Registration

  • Required: RN
  • Preferred: BSN strongly preferred
Boston medical center, Boston area, Best regional hospital, Best hospital, North Shore's largest provider, North Shore Medical Center, Massachusetts General Hospital, Brigham and Women's Hospital, Salem Hospital, Union Hospital, Designated stroke center, High-performing, Partners HealthCare, Community health, Community hospital system, Clinician, Massachusetts hospital, Electronic medical records, Epic EMRs, In-patient, Teaching, Academic medicine, Clinical ladder, Level III Trauma Center, Nationally recognized, Outpatient, Patient-focused care, Patient-Centered Medical Home, Provider, Wellness, U.S. New - World Report ranking, Expert, Serve, Care, Healthcare, Multispecialty, Boston, North Shore, Marblehead, Salem, Peabody, Danvers, Lynnfield, Lynn, Melrose, Wakefield, Manchester, Nahant, Topsfield, Wenham, Middleton, Malden, Revere, Beverly, Rowley, Saugus, Swampscott

Job by : Indeed

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