Position Overview
DescriptionClinical Manager is responsible for overseeing the continuity of patient care in the ALIGN-CARE Geriatric Surgery Co-Management program. Patients will be 65 years or older, frail, community-based, considering surgery. Estimated program size will begin at around 50 patients and grow to 200-250 by the 2nd year.
ResponsibilitiesPatients will be initially seen in the outpatient setting, assessed for surgical risks, and provided care plans to optimize health prior to the surgery. The nurse Clinical Manager will be responsible for components of team-based initial assessment of patient candidates, as well as follow-up tracking and phone calls for education and counseling pre-hospitalization, peri-operatively, and post-operatively. Following discharge from the hospital, Clinical Manager will follow-up with the patient via telephone and transitional care management workflow for optimal post-operative care with the mission to reduce unnecessary return...