Nurse Care Manager - Oxford (147)


Under the direction of a Program Clinical Supervisor and Manager of BHH, the Nurse Care Manager is responsible for monitoring medical/primary care needs and identification of gaps in the care of the assigned census.  Additional duties include monitoring identified consumers' plans of care to ensure all medical needs are met as well as consulting with new members of the program.  The Nurse Care Manager will ensure consumer access to all available community supports.


Demonstrates commitment to the mission of the agency with a strong understanding and respect for the goals of agency activities.

Works with assigned Behavioral Health Home to identify consumers that meet eligibility for admission to the program.

Enhances communication and collaborative relationships with multidisciplinary healthcare team members and other community supports.

Effectively emphasizes continuity of care, thus reducing or eliminating fragmentation, duplication, and gaps in plan of care and service delivery.

Maintains a comprehensive working knowledge of community resources and network services for target population.

Reviews consumer medical needs through chart reviews, face-to-face contacts, and active case management; documents quarterly reviews and manages completion of paperwork related to consumers.

Utilizes the consumer's electronic health record (EHR) to ensure that documentation is complete, accurate, timely and meets regulatory and agency standards.

Follows policies and procedures with regard to the EHR to ensure that the services provided are consistent with best practices, assessment and/or treatment goals.

Responsible for ensuring that staff understands the medical needs and symptoms of the consumers.

Provides on-going consumer education and support related to their illnesses, personal hygiene, and safety.

Develops and facilitates educational groups for consumers with specific medical/health needs.

Attends care manager meetings to facilitate case presentation discussions, ensuring appropriate level of care and all consumer medical needs are identified and provided.

Obtains necessary paperwork to maintain compliance with Department of Health and Human Service regulations.

Uses Health Information Technology to support the monitoring of medical needs, gaps in care and BHH quality metrics.

Uses personal vehicle as may be required for consumer transportation, outreach in the community, home visits, and/or agency related business.


Communicates effectively both verbally and in writing, establishes positive public relations and interacts effectively with a diverse array of professionals and consumers.

Maintains appropriate boundaries and displays respect and courtesy to all internal and external customers.

Demonstrates patience, caring, compassion, and sensitivity toward consumers.

Completes and submits required documentation in a timely manner and according to policies and procedures.

Participates in training to maintain or enhance job skills.

Ensures that confidentiality is maintained at all times in accordance with federal, state, and agency standards.

Adheres to the agency's Risk and Safety Management Programs.

Adheres to the agency's Organizational Standards for Performance (see attached).

Functions in a cost-effective manner with regard to the utilization of time, supplies and other agency resources.

Attends meetings and supervisions as required and necessary for the position.

Promotes and fosters effective relations, both inside and outside of the agency.

May perform other related duties as required.


Duties require knowledge of nursing equivalent to completion of an Associate's degree in Nursing plus additional courses and three to five years of related experience, or equivalent combination of education and experience.  Must be licensed as a Registered Nurse by the State of Maine. 

Must possess a valid State of Maine driver's license. 


Detail-oriented with good organizational and time management skills

Ability to manage multiple priorities and tasks, and consistently meet deadlines.

Ability to demonstrate good problem solving and critical thinking skills.

Ability to work effectively on a multi-disciplinary team.

Ability to assess situations for personal and consumer safety.

Ability to respond effectively in crisis situations.

Proficient with the use of a computer and job-specific software applications


Normal office environment, not subject to extremes in temperature, noise, odors, etc.

May spend extended periods at terminal, on telephone, or operating other office machines, requiring eye-hand coordination and finger dexterity.

More than half of time spent in normal office setting.

The above statements are intended to describe the general nature and level of work being performed by people assigned to do this job.  The above is not intended to be an exhaustive list of all responsibilities and duties required.  The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position.

*External and internal applicants, as well as position incumbents who become disabled as defined under the Americans With Disabilities Act, must be able to perform the essential job functions (as listed) either unaided or with the assistance of a reasonable accommodation to be determined by management on a case by case basis.

This job description does not constitute an employment agreement between the employer and employee, and is subject to change by the employer, as the needs of the employer and requirements of the job change.