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Outpatient Care Manager - Brooklyn Center

Brooklyn Center, MN

Blaze Health

Blaze Health is a joint venture between Blue Cross and Blue Shield of Minnesota and North Memorial Health, which includes North Memorial Health primary care clinics, specialty care clinics and hospice. Our customers are at the heart of everything we do. Blaze Health is committed to transforming healthcare to remove the hassle and make it more accessible, more affordable and less complicated. Direct communication between care provider and insurer will help make the care experience better.

North Memorial Health in partnership with Blue Cross and Blue Shield of Minnesota launched a joint venture called Blaze Health which includes North Memorial Health’s primary care clinics, specialty care clinics, and hospice.

About this position

Care Manager: As an integral member of the health care team, the care manager provides clinically-based care coordination to support the delivery of quality customer care as efficiently as possible. The care manager has accountability for individual customers ensuring quality clinical outcomes and appropriate resource management within an assigned caseload. With the customer, family, and health care team, the care manager creates and organizes a care plan (or contributes to an existing care plan) appropriate to the customer's needs and resources and ensures that the customer is receiving the right care, at the right level across the continuum.

 

What we’ll expect from you

• Promotes customer-centered care based on jointly determined health care goals and priorities.
• Ability to reach out to customers to ensure program understanding and enroll in appropriate customer programs supported by their clinic or payer.
• Functions as a resource to customer care units, ambulatory clinics and medical staff regarding the payer products and panel the customer is aligned with.
• Applies clinical judgment to determine level of care and resources needed.
• Monitors, trends and records customer response to disease, illness, treatment.
• Documents appropriately as required by public and payer systems.
• Projects a positive image through professional behavior and building positive relationships with customers, families, providers, and other staff.
• Accepts other duties as assigned to promote the accomplishment of organizational goals.
• The team member is accountable to demonstrate proficiency for the skills outlined in the appropriate position skills list.
• The team member is accountable to maintain skill proficiency, including improvement where deemed necessary, and upgrading any additional or new skills on the appropriate position skills list.



Lead Care Manager – Additional Accountabilities:
• Provides leadership over the general operations of the care management team and will assist in program performance and improvement.
• Serves as the central point of contact for communication between the team and outside stakeholders.
• Works with the Manager and the Program Assistant to ensure the program meets all payor requirements.
• Participates in preparation for annual audits and other compliance activities.
• Works with program leadership to implement new processes and requirements.
• Assists the care management team in problem solving and responding to member or provider inquiries. • Recognizes and complies with legal, regulatory, accrediting and procedural requirements related to area of responsibility.
• Understands and follows principles and standards as outlined in North Memorial's Corporate Code of Conduct.
• Protects customer and team member privacy and only accesses customer and/or team member related information as needed to perform job duties.
• Reports violations or areas of concern to supervisor or Corporate Compliance Officer via established methods of communication.

• Understands and follows principles and standards as outlined in North Memorial's Corporate Code of Conduct.
• Protects customer and team member privacy and only accesses customer and/or team member related information as needed to perform job duties.
• Reports violations or areas of concern to supervisor or Corporate Compliance Officer via established methods of communication.
• Recognizes and complies with legal, regulatory, accrediting and procedural requirements related to area of responsibility.
• Understands and follows principles and standards as outlined in North Memorial's Corporate Code of Conduct.
• Protects customer and team member privacy and only accesses customer and/or team member related information as needed to perform job duties.
• Reports violations or areas of concern to supervisor or Corporate Compliance Officer via established methods of communication.

Interested? Here are our requirements

Education

• Graduate from an accredited school of nursing required; BSN or BAN preferred; or BSW from an accredited school of social work.   

Experience, Knowledge, Skills, Abilities 

• RN Required. Experience with transgender or gender care clinic preferred. Care coordination experience preferred. Previous MSHO Experience preferred.
• Clinic experience preferred. • Excellent verbal and written communication skills required.
• Needs assessment skills.
• Evaluation skills.
• Knowledge of relevant policies and procedures.
• Customer interaction and motivational skills.
• Customer triage skills.
• Project a positive image through professional behavior and building positive relationships with customers, families, providers and other staff.
• Demonstrated ability to collaborate with other disciplines both in and out of health care system.
• Demonstrated ability to problem solve proactively using sound judgment based on factual information and clinical knowledge.
• Demonstrated ability to use behavioral strategies such as motivational interviewing.
• Demonstrated understanding of concepts associated with utilization management.      

Licensure/Certification(s) Mandatory

• Registered Nurse OR
- State Requirement
• Licensed Social Worker
- State Requirement

 

    

Posting Date:


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EEO/AA STATEMENT

North Memorial Health is an equal employment and affirmative action employer. North Memorial Health does not discriminate against any employee or applicant for employment because of race, color, religion, sex, national origin, age, disability, genetic information, marital status, veteran status, sexual orientation, gender identity, creed, status with respect to public assistance, or other protected class status. North Memorial Health provides reasonable accommodation to disabled applicants and employees and takes affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to protected class status. If you believe that you have been treated in a way that does not conform to these statements, please contact our HR Service Center: 763-581-6947. If you need a reasonable accommodation, due to a disability, or to assist with the application process, please contact our HR Service Center: 763-581-6947.



INSPECTION OF AAP
Blaze Health, LLC is a Federal government contractor or subcontractor.
As a part of our obligations under law, we must develop a written Affirmative Action Program for Individuals with Disabilities and Protected Veterans, as specified by law (AAP).
This AAP is available for inspection by applicants and employees in the Human Resources Office during normal business hours.


Explore Blaze Health

A big bang in healthcare.

Blaze Health - a new collaboration between Blue Cross and Blue Shield of Minnesota and North Memorial Health - is changing the relationship between provider and payer.

Explore Blaze Health

A big bang in healthcare.

Blaze Health was formed to remove the customer from the "sticky middle" and challenge the status quo by prioritizing customer outcomes over short- term financial gains.

Explore Blaze Health

A big bang in healthcare.

We are truly revolutionizing healthcare for customers and team members alike, offering a competitive and comprehensive benefits program and supporting a healthy work/life balance.

Explore Blaze Health

A big bang in healthcare.

Join a team that pioneers an innovative solution to unmask healthcare complexity. This is Blaze Health, and we are changing the universe of healthcare.

Picture of Dr. Fruechte, Blaze Health Cardiologist
Blaze Health is large enough to provide cutting-edge, comprehensive medical care, and small enough to feel like family.Dr. Fruechte, Blaze Health Cardiologist

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