The High-Risk Care Manager (HRCM) within the Complex Care Management department provides comprehensive care management and transition of care services to Michigan Medicine patients with complex medical and psychosocial needs. They possess extensive experience working with vulnerable populations. They have a strong skill set in engagement, problem-solving, coordination across specialties/services, and accessing programs and resources that address unmet medical needs and social determinants of health both within and outside of Michigan Medicine.
As liaison for the patient and the patients? multidisciplinary health care team, the HRCM works to engage patients with a focus on improving patient experience, identifying and connecting to resources, strengthening care teams, improving health outcomes, and reducing costs. Care coordination involves engagement, assessment, advocacy, collaboration, and organization of patient care needs to facilitate optimal delivery of health care services.
Assigned duties and responsibilities include, but are not limited to:
Work with a targeted population of patients and provide care coordination services including regular scheduled phone/video visits Provide coordination of unmet medical needs, support, and collaboration with the patient, family members, treating providers, and community agencies. Facilitate adequate and timely communication between the patient and care team members/providers, particularly during critical periods of transition Ensure coordination of healthcare services across a variety of disciplines and settings as patients transfer between different locations and different levels of care. Assist patients in achieving optimum stability of health status by assisting patients, when necessary, in placing calls, completing applications, and advocating for available services. Assessment of mental, physical, behavioral, cultural, social, financial, functional, and environmental factors and how these factors impact the patient?s ability to access healthcare. Facilitate appointment scheduling, and arrange non-emergency transportation as appropriate. Assist patient and treatment team in identifying available/appropriate treatment options and opportunities to improve the quality and efficacy of care. Serve as a liaison and internal consultant to other health system staff and departments regarding care management, and clinical and community resource issues. Maintain consistent and timely documentation within the EMR (MiChart); meet required program documentation metrics. Attend medical, specialty, and community appointments with patients when appropriate. Collaborate with PCP and others on the health care team to ensure the exchange of critical information including regular updates to the care team via case conference, email, EMR or phone. Attend appropriate staff and community meetings such as daily huddles, and other departmental and community meetings as required. Participate in Quality Improvement activities as assigned. Bachelor?s degree in Social Work, Psychology, Public Health, Nursing or other related field. Two or more years of progressively responsible experience providing care/case management services. Ability to work with patients to identify strengths and barriers and develop an individualized, patient-centered plan of care. Strong knowledge of common medical conditions, symptoms, and treatment. Strong knowledge of community resources and government-funded entitlement programs such as Medicaid, Medicare, Social Security, etc. Excellent interpersonal communication skills. Skill in problem-solving, decision-making, and crisis intervention. A commitment to promoting and embracing diversity, equity, and inclusion (DEI) efforts and cultural sensitivity to better serve patients and their families. An understanding of harm reduction principles. Strong organizational skills and written and verbal communication skills. Dedication to customer service and ability to work within a team-based framework. Excellent patient engagement skills Ability to work independently and collaboratively. Demonstrated computer competency. Proficiency in keeping accurate and timely clinical records in EMR Master?s degree in a related field Experience working with mental health/substance use disorder Strong knowledge of the Michigan Medicine Health System Experience working with children and young adults in the medical system Strong commitment to social justice work Specific knowledge and relationships with local community agencies and resources Experience working in a large, academic healthcare setting Current Case Management certification or the ability to become certified within one year of employment Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.
The University of Michigan is an equal opportunity/affirmative action employer.
About University of Michigan - Ann Arbor
A great university is made so by its faculty and staff, and Michigan is recognized as one of the best universities to work for in the country. The Michigan culture is known for engaging faculty and staff in all facets of the university to create a workplace that is vibrant and stimulating.For two consecutive years, the Chronicle of Higher Education has placed U-M in its "Great Colleges to Work For" survey. In particular, the university earns high marks for strong relations between faculty and administrators, a collaborative system of governance, strong pay and benefits, and a healthy work/life balance.
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