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Nurse Care Manager LPN or RN (Health Care Home)

Hopewell Center-Downtown St. Louis | St. Louis, MO | Full Time

Job Description


Nurse Care Managers assist in managing and preventing physical health care concerns for the youth and their families, in addition to behavioral health care needs, taking a "whole person" approach. 


1)Tracks that all required assessments and screenings are completed for each client, in accordance with performance measures, and follows-up if necessary.

2)Assists in developing the treatment plan for clients, and identifying 1 or 2 healthcare goals.

3)Champions healthy lifestyle changes, including tobacco prevention and cessation, nutrition and physical activity.

4)Champions preventive care efforts on healthcare issues and alcohol and drug abuse.

5)Manages HIT tools and reports on HH caseload, received from HH director, and reviews for accuracy, outlying prescription patterns and practices.

6)Monitors HIT tools and reports for treatment and medication alerts and hospital admissions/discharges.

7)Makes the initial contact with the hospital regarding client admission/discharge.

8)Assists with Department of Mental Health state-operated facilities and general hospitals in discharge planning of HH caseload.

9)Coordinates with the CSS and Care Team on treatment and medication alerts and hospital admissions/discharges.

10)Facilitate health education groups and/or activities for clients/staff/community, or refer to other PSR staff leading groups (per the criteria and guidelines of the specific programs/curriculum).

11)Consult with CSSs about identified health conditions of their clients and provide education training on medical diseases, health coaching and medications

12)Support and educate CSS staff on health coaching, chronic diseases, healthy lifestyle choices and medication adherence.

13)Provide technical assistance to CSSs on the use of Cyber Access and running a Patient Profile Report.

14)Responsible for performing roles supported by the community support specialist

(for clients' w/o a CSS).

15) Maintains a time log of HH activities with DMH and reports CE courses/training.

16) Fallows through on performance measures.

17)Communicates algorithm concerns, problems or suggestions to HH director.

18)Assists in developing the treatment plan for clients, and identifying 1 or 2 healthcare goals.

19)Assists with developing and enhancing wellness initiatives such as, but not limited to, wellness support groups, nutrition and physical activity programs, periodic staff and consumer education classes, consumer health fairs and screenings.

20)Coordinates care with MO HealthNet contracted pharmacies and providers in the community, and federal qualified health center (FQHC) clinical staff.


Possession of an LPN or RN certificate from an accredited school of nursing. One year of experience in working with the mentally ill. Attendance at all required Department of Mental Health training for this position is required. 

CERTIFICATION OR Licenses REQUIRED: Registered Nurse (RN) or Licenses Practical Nurse (LPN)