Care Manager Associate job description
- Job Title: Nurse/Allied Health Professional (Care Manager Associate)
- Grade: Band 5
- Accountable to: Clinical Team Leader, Birmingham OwnHealth
Span of Authority
Birmingham OwnHealth Service Delivery Manager, Regional Head of Operations, UK Pfizer Health Solutions, external stakeholders: primary health care teams
Role Summary
- To support Care Managers in promoting wellness, improved outcomes and self care within a defined population, within the support level only, of members with a long term condition(s) and support their appropriate utilisation of health services.
- To work with the individual member and providers of care to develop and implement individual health plans and provide support to the member in self management.
- To undertake member enrolment and ongoing assessment, planning, implementation, co-ordination and review of health plans and encourage the appropriate utilisation of services to meet member’s health needs. This will be achieved through proactive telephone communication using health behaviour change coaching, facilitated by decision support software and the co-ordination of available healthcare resources.
- Care management will take place within the philosophy of enabling and promoting self care, self management and independence.
The job description is underpinned by the competency framework and is not intended to be an exhaustive list of tasks.
Main duties and responsibilities
1. Proactively managing long term conditions
1.1 Plan and conduct telephone consultations with members to assess and monitor needs, plan care, review effectiveness of services and support self-management.
1.2 Synthesise member information and clinical knowledge to plan, implement, monitor and review individualised health plans and make appropriate interventions to attain agreed goals and reduce risk of deterioration/exacerbation.
1.3 Work collaboratively with member, members of the family and caregivers, General Practitioner, hospital and other health services to develop and implement a health plan using the eight care management priority framework.
1.4 Know the limits of own clinical competence and knowledge and refer appropriately to more experienced colleagues when the situation calls for it.
1.5 Make referrals to senior nursing colleagues of complex cases and those requiring a high level of nursing experience and/or knowledge
2. Managing information
2.1 Maintain timely and appropriate data collection using OwnHealth software.
2.2 Complete assessment and monitoring of the member utilising approved tools and procedures.
3. Supporting self care, self management and enabling independence
3.1 Provide education and coaching to members and caregivers on disease processes, disease management and health promotion to enable them to make informed decisions regarding self-care and maintain wellness.
3.2 Engage and coach the member around the health plan and health behaviour change to motivate and empower the member to achieve agreed goals.
Leading Care Co-ordination
3.3 Liaise with local service providers to arrange and coordinate services across the continuum of care.
3.4 Using advanced communication and interpersonal skills act as liaison with providers, members, family members, health services, community sources and health plan.
3.5 Maintain an appropriate level of contact with other service providers and share information in an appropriate and timely manner.
4. Professional effectiveness
4.1 Work in collaboration with other health practitioners to ensure optimal results and strengthen their relationship with the member.
4.2 Understand own professional boundaries and seek the support from senior team colleagues in a timely manner when required
4.3 Support teamwork and display professionalism during daily job responsibilities. Participate actively in team meetings.
4.4 Communicate with the Care Manager Team Leader/assigned mentor with complex, problematic cases and operational issues and seek appropriate support.
4.5 Maintain and comply with NHS Direct and project policies and procedures.
4.6 Maintain a high level of professionalism in manner and communication.
4.7 Maintenance and development of current knowledge of clinical area, pharmacology, interpersonal skills, coaching for health behaviour change, health care ethics and legal aspects of care management.
4.8 Undertake audit and supervision as stipulated, participate in performance management, self-assessment and maintain a personal development plan/CPD portfolio.
4.9 To adhere to and implement national and local policies and procedures and work within the NMC / HPC Code of Professional Conduct.
5. General
- Staff must at all times carry out their responsibilities with due regard to NHS Direct policies and procedures, specifically in relation to Equal Opportunities, Health & Safety, Confidentiality and Data Protection.
- All staff have a responsibility to participate in the NHS Direct Appraisal Scheme and to contribute both to their own development, and the development of any staff they appraise or are responsible for.
The above Job Description is not intended to be exhaustive. The duties and responsibilities may therefore vary over time according to the changing needs of the organisation.
Confidentiality
In the course of employment NHS Direct staff will have access to confidential information relating to NHS Direct business. Staff are required to exercise due consideration in the way they use such information and should not act in any way, which might be prejudicial to the interests of the organisation. Information which may be included in the category which requires extra consideration covers both access and to the general business of the NHS Direct and information regarding individuals. If staff are in any doubt regarding the use of information in the pursuit of their duties, they should seek advice from their manager before communicating such information to any third party.
Data Protection
NHS Direct is registered under the Data Protection Act 1998. Staff must not at any time use the personal data held by NHS Direct for a purpose not described in the register entry or disclose such data to a third party. If staff are in any doubt regarding what they should or should not do in connection with the Data Protection Act then they must contact the Director of ICT.
Health & Safety
Staff must be aware of the responsibility placed on them under the Health and Safety at Work Act (1974) to maintain a healthy and safe working environment for both staff and visitors. Staff also have a duty to observe their obligations to NHS Direct and department Health and Safety policies, and to maintain awareness of safe practices and assessment of risk.
Financial Regulations
All staff are responsible for the security of the property of NHS Direct, avoiding loss or damage of property, and should be economical and efficient in the use of resources. Staff should conform with the requirements of the Standing Orders, Standing Financial Instructions and other financial procedures including the Code of Conduct and Accountability and the Fraud and Corruption Policy.
