Job description:

SUMMARY OF DUTIES: The Care Manager performs care management support

services for seriously ill patients suffering from chronic diseases such as chronic kidney

disease, diabetes mellitus, chronic obstructive pulmonary disease, congestive heart

failure, behavioral health, and substance abuse disorders. The Care Manager works in

collaboration and partnership with chronically ill patients and their family/caregiver(s),

clinic providers and community resource providers using in a team approach to increase

patients’ ability for self-management and shared decision-making. This position requires

a strong background in nursing and medical terminology. The ideal candidate will

possess excellent case management skills and be familiar working with high-risk

patients.

PRIMARY RESPONSIBILITIES:

Fulfills Freedmen Medicine’s mission to enhance patient’s lives through quality

healthcare to those in need while providing appropriate physical, mental, and

emotional care for the whole person.

Acknowledges acceptance of identified patient load and advocates for their

patients and communicates with other healthcare providers to accurately update

documents and schedule appointments.

Validates enrollment of chronically ill patients based on provider requests.
Coordinates continuity of patient care with primary care providers, specialty care

providers and community resources to affect positive health outcomes in an effort

to decrease readmission rates.

Conducts minimum of one 40-minute session of telephone or in-person

counseling and education per month to each care management patient on roster

and ensures compliance with established time frames for specific services and

functions.

Freedmen’s Medicine

Job Description: Chronic Care Manager

Complies with documentation requirements of the Care Management program by

carrying out the care plan with the patient, family/caregiver (s) and providers and

records results in the electronic Health Record (HER) and other related systems.

Monitors adherence to care plans, evaluates effectiveness, monitors patient

progress in a timely manner, facilitates changes as needed, and ensures the

Care Management supervisor is aware of significant changes in patient’s

condition and disposition.

Work closely with community resources and providers to manage the patient’s

day to day needs involving: symptom control, medication management, and

provide patient and family education.

Provides patient health counseling, education and instruction and educates

patient and family/caregiver(s) about relevant community resources.

Supports patient self-management of disease and behavior modification

interventions.

Provide weekly updates to Care Management Supervisor on adherence to

identified key performance indicators and supporting metrics and communicates

plan to mitigate performance issues.

Join our team as a Care Manager where you can make a meaningful impact on the lives

of patients by providing exceptional care coordination and support.

Job Type: Full-time

Benefits:

401(k) matching
Health insurance
License reimbursement
Paid sick time
Paid time off

Schedule:

8 hour shift
Monday to Friday
No nights
No weekends

Experience:

Nursing: 2 years (Preferred)

License/Certification:

LPN License (Required)

Location:

Washington, DC 20003 (Preferred)

Ability to Commute:

Washington, DC 20003 (Required)

Work Location: In person

Pay: $25.00 - $28.00 per hour

Work Location: In person

Freedmen's Medicine

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Chronic Care Manager