Lead Chronic Care Manager

Purpose of Job

This position is responsible for leading Ridgeview's Chronic Care Management initiatives, including oversight of the payer delegation program and development of an internal CCM model. The Lead CCM will also serve as a patient advocate to assist rising risk and high risk/complex chronic patients in reaching optimal function and health. Role of CCM is to assist in increasing preventative visits/screenings, decrease care gaps, preventing emergency department visits that are avoidable or patients who highly utilize, decrease hospitalization and hospital readmissions and ultimately lower health care costs.

Job Functions

1. Design and implement Ridgeview's Chronic Care Management (CCM) program to improve patient outcomes, reduce hospital utilization, and lower healthcare costs.
2. Engage and manage high-risk patients using clinical data to proactively close care gaps, precent avoidable emergency visits, and support chronic disease management.
3. Coordinate and facilitate interdisciplinary care planning across departments and external partners to ensure seamless care delivery and appropriate resource utilization.
4. Monitor and optimize program performance, including quality indicators, patient engagement, and financial impact, while ensuring compliance with regulatory and payer requirements.
5. Performs other duties as assigned.

Minimum Education/Work Experience

• Bachelor's in Nursing degree required
• 3 years of clinical nursing/adulatory care experience
• Registered Nurse licensed in State of Minnesota

Knowledge/Skills/Abilities

• Ability to meet and maintain the necessary background checks as aligned with position functions
• Ability to communicate in the English language for effective written and verbal correspondence in order to complete job functions as mentioned above
• Ability to demonstrate exceptional communication and customer service skills
• Capable of making independent decisions with the use of good critical thinking and problem-solving skills
• Ability to function competently in stressful situations and a changing work environment, and respond appropriately to unpredictable situations and diverse patient populations
• Possess a strong understanding of nursing, occupational health, ergonomics and business
• Ability to read, analyze and interpret common scientific and technical journals, financial reports and legal documents
• Ability to respond to common injuries or complaints from customers/vendors, regulatory agencies or members of the business community
• Ability to define problems, collect data, establish facts and draw valid conclusion
• Ability to change work locations with or without notice
• Knowledge of basic computer functions and Microsoft Office applications
• Strong interpersonal skills

License/Certifications

• Current professional nurse licensure in Minnesota or if licensed in another state, a permit from the Minnesota Board of Nursing while the license application is in process

Preferred Qualifications

• 5+ years of clinical nursing/ambulatory care experience
• Certified Case Manage (CCM)
• Previous RN Care Coordination, Case Management, Care Navigation experience
• Working knowledge of motivational interviewing, behavioral activation and shared decision making

Benefits

Ridgeview strives to provide comprehensive and market competitive benefits to meet the needs of our employees and their families. Click here to view the benefits available.

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