Summary The Community Health Team Case Manager promotes the Patient-Centered Care Medical Home by working with all Community Health Team (CHT) members in the coordination of patient care with Blueprint participating primary care practices. Patient care will require visiting patients in multiple settings including the CHT office, in Primary Care office, in patient’s home, in-patient and long-term care settings. The CHT Case Manager partners with the physicians and other members of the healthcare delivery team to establish improved coordination of the healthcare delivery system, ensuring that patients and families are involved in chronic disease self-management. The CHT Case Manager is responsible for assisting CHT leadership in the implementation of operations and monitoring of outcomes. Minimum Education Graduate of an accredited school of nursing, BSN preferred. Minimum Work Experience 3 to 5 years case management experience with coordination of community services, home care, or chronic disease care management. Required Licenses/Certifications Current Vermont RN license. BLS Certification through American Heart Association. Drivers License in good standing with reliable transportation. Willingness and ability to utilize personal vehicle for business purposes. Required Skills, Knowledge, and Abilities Knowledge of clinical practice skills based on theory and consistent with policy and procedure. Ability to build working relationships with medical professionals and community resource advocates. Strong written/verbal communication and negotiation skills. Knowledge of contractual or risk arrangements; and ability to effect change, perform ongoing evaluation and critical analysis, plan and organize effectively and promote client/family self-efficacy. Ability to serve on a team. Problem-solving and decision-making skills. Knowledge of community services, healthcare services, human behavior/ dynamics, the healthcare delivery and financing systems, and clinical standards and outcomes. Basic Microsoft desktop application and navigation skills required. Pay Range = $39.09 - $66.14 PM24