Become A Clinical Care Manager

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Working As A Clinical Care Manager

Communicating with Supervisors, Peers, or Subordinates
Making Decisions and Solving Problems
Establishing and Maintaining Interpersonal Relationships
Evaluating Information to Determine Compliance with Standards
Developing and Building Teams

Deal with People
Unpleasant/Angry People
Mostly Sitting
Make Decisions
$94,500
Average Salary

What Does A Clinical Care Manager Do At Northwell Health

* Communicates with Medical Group, Voluntary and Community Physicians to help facilitate appropriate patient referrals in a timely manner.
* Provides telephone patient triage and physician outreach to coordinate proper patient healthcare.
* Triages clinical needs and coordinates clinical care for patients.
* Communicates with referrers including hospital administrators, physicians, support staff, patients and families.
* Processes, tracks documents, and directs patient care throughout the Health System.
* Maintains documentation for patient inquiries.
* Collects pertinent insurance information and matches for physician participation.
* Promotes relationships between physicians to enhance physician involvement with Health System and for best practice patient care.
* May review patient's prescriptions and medications, as needed.
* Performs related duties, as required

What Does A Clinical Care Manager Do At Wheeler Clinic

* Conducts program specific screening and evaluation, and formulates diagnosis in accordance with the Diagnostic Statistical Manual (DSM).
* Develops and documents, clear clinical formulation and treatment plans that are individualized, measurable, developed in collaboration with the client, family, and other collaterals involved with the child.
* Demonstrates knowledge of psychopathology and other behavioral health concerns and primary modalities of psychotherapeutic intervention.
* Triages clinical emergencies and implements program specific safety and consultation protocols.
* Utilizes best practices and evidenced based practice models where appropriate and adheres to model and program expectations.
* Communicates in a positive, effective manner with children, foster families, biological families, and all internal and external providers involved as required.
* Attends all necessary internal and external meetings with foster care staff, providers, foster parents, and children associated with the foster care program.
* Provides care management services to help foster children stabilize in placement and improve overall functioning.
* Provides support/direction to foster families to assist them in caring for the children placed in their homes.
* Monitors foster parent compliance with program expectations/policy and assists families in meeting these requirements.
* Works with biological families, where appropriate, to help them to support the child while in foster placement and/or to prepare for their return home.
* Meets direct service productivity goals as defined by the program.
* Demonstrates knowledge of program/department/agency goals and target outcomes, and adheres to practice standards and to data collection and reporting protocols.
* Attends and is prepared for scheduled supervision.
* Seeks additional supervision or consultation as needed and follows through with supervisory directives.
* Documents all client related information in compliance with agency policy and DCF contractual standards for child and/or families within the foster care program.
* Provides service in the office and/or community settings outside the office (e.g., homes, schools, hospitals, institutions, other community locations) as defined by the program.
* Provides after hours on call response to foster children and their families on a rotating basis with other foster care program staff.
* Promotes and supports the foster care program within the community, and assists with recruitment and training as needed.
* Wheeler Clinic is an EO Employer
* M/F/Veteran/Disability.
* All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status, or any other protected class.
* Affirmative
* Action Equal Opportunity Employer.
* EEO/M/F/Vet/Disabled
* Category:
* Clinical
* Facility:
* Plainville
* Department:
* Foster Care
* Schedule:
* Full

What Does A Clinical Care Manager Do At St. Mary's Good Samaritan

* Contributes to overall quality and safe care for patients by answering patients’ calls for help, taking their vital signs, and monitoring their behavior and physical condition for progress or deterioration as measured by patient satisfaction, quality audits, direct observation.
* Creates a positive patient experience by assisting patients with their activities of daily living including assisting with baths, ambulating, feeding, skin care, personal and oral hygiene and making occupied and unoccupied beds as measured by patient satisfaction quality audits and direct observation.
* Contributes to quality care and safety by assisting and performing procedures such as performing dressing changes, enemas, ostomy care, toileting, turning, cough and deep breathing, catheter care, collection of biological specimens, measuring and recording intake and output of fluids.
* Contributes to exceptional patient satisfaction by establishing a compassionate environment by timely responses to patients' needs, open communication and providing emotional, psychological.
* Contributes to safety and quality care by relaying information via charting and communicating to team members.
* Contributes to achievement of exceptional health care by functioning as a member of the team as measured by active participation in department initiatives, unit meetings, committees and special projects
* SSM Health will implement a new minimum wage of $11 per hour throughout its four-state system which will take effect in January 2017.
* This job is one impacted by this increase.
* Learn more here

What Does A Clinical Care Manager Do At UPMC

* Assist member with transition of care between health care facilities including sharing of clinical information and the plan of care.
* Conduct comprehensive face to face assessments that include the medical, behavioral, pharmacy, and social needs of the member.
* Review UPMC Health Plan data and documentation in the member electronic health records as appropriate and identify gaps in care based on clinical standards of care.
* Contact members with gaps in preventive health care services and assist them to schedule required screening or diagnostic tests with their providers.
* Assist member to schedule a follow up appointment after emergency room visits or hospitalizations.
* Document all activities in the Health Plan's care management tracking system following Health
* Plan standards and identify trends and opportunities for improvement based on information obtained from interaction with members and providers.
* Present or contribute to complex case reviews by the interdisciplinary team summarizing clinical and social history, healthcare resource utilization, case management interventions.
* Update the plan of care following review and communicate recommendations to the member and providers.
* Refer members to appropriate case management, health management, or lifestyle programs based on assessment data.
* Engage members in the Beating the Blues or other education or self management programs.
* Provide members with appropriate education materials or resources to enhance their knowledge and skills related to health or lifestyle management.
* Review member's current medication profile; identify issues related to medication adherence, and address with the member and providers as necessary.
* Refer member for Comprehensive Medication Review as appropriate.
* Successfully engage member to develop an individualized plan of care in collaboration with their primary care provider that promotes healthy lifestyles, closes gaps in care, and reduces unnecessary ER utilization and hospital readmissions.
* Coordinate and modify the care plan with member, caregivers, PCP, specialists, community resources, behavioral health contractor, and other health plan and system departments as appropriate

What Does A Clinical Care Manager Do At University of Rochester

* The Clinical Care Manager manages clinical aspects of patient centered medical home, working with the interdisciplinary medical team in the provision of patient care.
* May participate in supervision of other clinical staff members.
* Specific Responsibilities:
* Under general direction of the Site Medical Director, the Clinical Care Manager’s central role integrates and coordinates access and utilization management, proactive patient management, care facilitation and treatment planning functions.
* The Clinical Care Manager will demonstrate this commitment through implementation of the following:
* Coordinates medical care of patients identified as high risk by health risk assessment/appraisal or by physician clinical determination
* Assumes coordination role at the point of service and through targeted outreach and follow-up.
* Identifies patient groups with chronic diseases.
* Assists in developing and implementing population-based strategies to close gaps in medical care
* Identifies resources for patient self-management skills.
* Identifies resources for patient self-management skills.
* Assists in developing and implementing care plans for medically complex patients.
* Identifies barriers to a successful care management path.
* Coordinates use of clinical and ancillary resources within and outside of the health system to achieve treatment goals specified in the patient care plan.
* Participates in program development by:
* Assisting with planning short-range and long-range program goals for chronic disease management.
* Keeping abreast of organizational developments and practices that may impact operations by participating in continuing education courses, professional organizations and seminars, reading current literature and maintaining professional contacts in the community.
* Assisting with the development of current evidence based protocols, policies, work flow/flow sheets, guidelines, etc. related to the provision of care within the medical home model.
* Participating in committees as assigned.
* Interacts effectively with physicians, the home care team, patients, and their caregivers.
* Accountable for patient triage.
* Adheres to infection control/safety guidelines.
* Adheres to HIPAA, JCAHO, and OSHA regulations and policies

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How To Become A Clinical Care Manager

Most medical and health services managers have at least a bachelor’s degree before entering the field. However, master’s degrees are common and sometimes preferred by employers. Educational requirements vary by facility.

Education

Medical and health services managers typically need at least a bachelor’s degree to enter the occupation. However, master’s degrees are common and sometimes preferred by employers. Graduate programs often last between 2 and 3 years and may include up to 1 year of supervised administrative experience in a hospital or healthcare consulting setting.

Prospective medical and health services managers typically have a degree in health administration, health management, nursing, public health administration, or business administration. Degrees that focus on both management and healthcare combine business-related courses with courses in medical terminology, hospital organization, and health information systems. For example, a degree in health administration or health information management often includes courses in health services management, accounting and budgeting, human resources administration, strategic planning, law and ethics, health economics, and health information systems.

Work Experience in a Related Occupation

Many employers require prospective medical and health services managers to have some work experience in either an administrative or a clinical role in a hospital or other healthcare facility. For example, nursing home administrators usually have years of experience working as a registered nurse.

Others may begin their careers as medical records and health information technicians, administrative assistants, or financial clerks within a healthcare office.

Important Qualities

Analytical skills. Medical and health services managers must understand and follow current regulations and adapt to new laws.

Communication skills. These managers must effectively communicate policies and procedures with other health professionals and ensure their staff’s compliance with new laws and regulations.

Detail oriented. Medical and health services managers must pay attention to detail. They might be required to organize and maintain scheduling and billing information for very large facilities, such as hospitals.

Interpersonal skills. Medical and health services managers discuss staffing problems and patient information with other professionals, such as physicians and health insurance representatives.

Leadership skills. These managers are often responsible for finding creative solutions to staffing or other administrative problems. They must hire, train, motivate, and lead staff.

Technical skills. Medical and health services managers must stay up to date with advances in healthcare technology and data analytics. For example, they may need to use coding and classification software and electronic health record (EHR) systems as their facility adopts these technologies.

Licenses, Certifications, and Registrations

All states require licensure for nursing home administrators; requirements vary by state. In most states, these administrators must have a bachelor’s degree, complete a state-approved training program, and pass a national licensing exam. Some states also require applicants to pass a state-specific exam; others may require applicants to have previous work experience in a healthcare facility. Some states also require licensure for administrators in assisted-living facilities. For information on specific state-by-state licensure requirements, visit the National Association of Long Term Care Administrator Boards.

A license is typically not required in other areas of medical and health services management. However, some positions may require applicants to have a registered nurse or social worker license.

Although certification is not required, some managers choose to become certified. Certification is available in many areas of practice. For example, the Professional Association of Health Care Office Management offers certification in medical management, the American Health Information Management Association offers health information management certification, and the American College of Health Care Administrators offers the Certified Nursing Home Administrator and Certified Assisted Living Administrator distinctions.

Advancement

Medical and health services managers advance by moving into higher paying positions with more responsibility. Some health information managers, for example, can advance to become responsible for the entire hospital’s information systems. Other managers may advance to top executive positions within the organization.

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Clinical Care Manager jobs

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Top Skills for A Clinical Care Manager

Top Clinical Care Manager Skills

Mental Health Services
Medicaid
Substance Abuse Treatment

You can check out examples of real life uses of top skills on resumes here:

-Conducted clinical reviews and provided authorization of mental health services for Medicaid recipients.
Consult at least weekly with both Medical Directors regarding systems of care, acuity of Medicaid recipients.
Monitored adult partial programs, inpatient mental health and substance abuse treatment facilities to ensure medical necessity and effectiveness.
Provided telephone triage, crisis intervention and emergency authorizations.
Refer cases to Peer Advisor that do not meet medical necessity criteria3.