RN Complex Care Management Manager

Position Description Summary:

The RN Care Management (CC) Manager reports administratively to the Sr. VP for Clinical Strategy and clinically to the Medical Director of Integrated Care (MDoIC). The position provides clinical leadership and expertise in chronic disease management and care management practices. Provides direct oversight of Population Health (PH) RN staff and assures achievement of individual and team performance and productivity standards. Implements changes to effect continual improvement in services provided. Directly responsible for personnel actions including hiring, training, coaching, evaluating performance, monitoring time and attendance, and scheduling of team members. Monitors work product and division of work between team members to promote staff working at the top of the license. Develops staff in an environment that is motivating. Promotes effective communication between departments and entities, acting as a liaison to facilitate information sharing, collaborative problem solving and adequate provision of services; fosters and maintains collaborative relationships within the population health division and the organization. Knowledgeable of government payer requirements and benefits. Provides staff training to assure they remain compliant with provision of services within a variety of different payer types. Maintains skills in care coordination, disease management and patient transition management to allow for coverage during staffing shortages in the department. Performs other duties as assigned.

Strategies must align with Company's integrated Care Management continuum and complex care strategy, as well as realities of catchment healthcare care systems (physical and behavioral health (MHSUIDD) providers) contractual obligations and work flows. Core competencies include but are not limited to:

· Systems Leadership;

· Member/Member centered care;

· Evidence based best practices;

· Informatics; and

· Quality improvement.

This position may work with staff, members and family members as well as community stakeholders.

Note: This position requires access to and use of confidential healthcare information or protected health information (PHI) as described in laws addressing patient confidentiality, including, but not limited to, the federal HIPAA law, the Confidentiality of Alcohol and Substance Abuse Patient Records law, 42 CFR Part 2, and various state laws. As such, the individual filling this position shall be required to be trained regarding such laws and shall be required to observe those laws in his/her capacity as an employee of the Company. The individual filling this position shall also sign a confidentiality statement as an employee of the Company.

Essential Duties and Responsibilities: List in order of importance and Percentages equal to 100%

40%- Management:

The manager will provide supervision to CCMRN Team by observing and monitoring paperwork/documentation/data/reports to ensure that RN Complex Care Management activities are carried out within the Vaya Health catchment area in an effective manner. Participate in the development and validation of data and reporting projects relative to RN Complex Care Management activities. Work in collaboration with Complex Care Management and Care Management Strategy leadership team to identify, develop and implement ongoing complex care improvement. Provide coaching to supervisors and employees to ensure continuous improvement of performance in meeting the needs of members, Vaya Health and community partners. Conduct performance reviews as required and conduct employee trainings to include but not limited to policies and procedures and service definitions, etc.

30% Managed Care Treatment Planning Care Management:

The Manager will ensure that teams have knowledge of duties described below and carry out these duties by providing direct supervision. The Manager may provide coverage in situations that require additional support such as staff shortages or an elevated need for services.

Oversight activities include but not limited to the following:

· Team compliance with Division of Medical Assistance and Division of MHDDSAS Contract with specific emphasis on Care Management roles and responsibilities.

· Team compliance with Complex Care and Care Management Continuum and Vaya policies and procedures.

· Team Risk Management- Proactively ensures individuals identified as a Special Needs enrollee that have treatment needs or require regular monitoring have a Behavioral Health Clinical Home and a Medical Home are assigned and receives outreach in a timely way.

· Ensures through supervision and in person CCMRN skill observation, member education regarding chronic or acute conditions, medication management, and care planning (including how to avoid a medical crisis).

· Ensures person centered principles are utilized by the CCMRN and the team in care planning activities for individuals through fidelity reviews or other CCMRN quality oversight processes.

· Provides support to CCMRN in addressing barriers to care for members through convening key providers and others to address needs of the individual or populations at the individual or system level.

· Proactively works with CCMRN team to identify gaps in services and intervenes to ensure that the individuals and specialty populations receive appropriate care.

· Uses data, chart review and supervision to measures results of intervention and treatment, including reduction in high risk events and inappropriate service utilization.

· Ensures that CCMRN services for the individual are coordinated across the Company system and with other healthcare and social determinant systems.

· Appropriately escalates high-risk scenarios to appropriate leadership. High risk can involve Health & Safety of an individuals served, staff or organizational risk.

· Understand the role of and collaborate with PH Division Teams re routine care planning, discharge planning teams, transitional care plans, educating staff and members regarding network services and supports with consideration of medical necessity, funding eligibility and appropriateness of recommendations relative to person-centered, recovery principles and known best/appropriate practice.

· Ensures CCMRN Team identifies and communicates gaps in care related to network adequacy to Network Department for healthcare needs; coordinates with FastTrack process; notifies Company Network of provider contractual concerns or through established process if quality of care or health and safety concerns.

· Ensure CCMRN Team notifies and updates assigned provider if currently engaged; provides support to the CCM if provider does not engage or follow up appropriately.

· Participate in the development and implementation of best practice complex care and Care Management strategies as identified by Vaya Health; and

· Provide proactive and clear supervision supported by data to ensure individuals and teams are meeting departmental and organizational benchmarks.

· Collaborate with key stakeholders, network providers, and non-network providers with particular attention to primary care, health departments, and healthcare systems.

25% Collaboration:

The Manager will ensure team supervisors and teams to ensure organizational and community partner collaboration. This position will interface with key stakeholders and is responsible for understanding Company organizational goals, initiatives and requirements in order to effectively communicate and facilitate collaborative partnerships. This position is also expected to provide information from key stakeholder interactions to the appropriate departments and teams to improve the care continuum for

5%

Other duties as assigned.

Supervisory Responsibilities:

Population Health RN Team.

This position supervises their team by observing and monitoring paperwork/documentation to ensure that Complex Care Management activities are carried out within the Vaya Health catchment area in an effective manner. The RN CCM Manager will provide coaching to employees to ensure continuous improvement of performance in meeting the needs of members and communities. Will conduct performance reviews as required and conduct employee trainings to include but not limited to policies and procedures and service definitions. The Manager will work with employee to mediate dissatisfaction within the community.

Requirements:

Education and Experience:

An RN degree in nursing and considerable experience in behavioral health, or equivalent combination of education and experience are required.

Mental/Physical Demands:

Person in this position is required to have close visual acuity to perform activities that include viewing a computer terminal; and extensive reading. Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers. Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.

Knowledge, Skills and Abilities:

Thorough knowledge of community-based programs and eligibility criteria pertaining behavioral health, IDD and other healthcare programs; preference for Basic Life Saving certification, thorough knowledge of the policies and practices of case management/Care Management; skill in dealing with members and their families in a tactful manner; skill in the use of personal computers, related software applications, hardware and peripheral equipment; ability to maintain accurate records and files; ability to review and analyze data to assure effective and efficient use of resources, ability to communicate ideas effectively in both oral and written formats; ability to maintain the confidentiality of members; ability to establish effective working relationships with associates, members, their families, social workers, medical practices, and the general public. Ability to travel and work with members and their families in office-based, home and/or community settings.

Proficiency in Microsoft Office products (such as Word, Excel, Outlook, PowerPoint, etc.) and Company information system is required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Licensure:

Must be licensed as a registered nurse in North Carolina

Driving on Company Business:

This position requires driving a personal vehicle for Vaya Health Business in accordance with 216.02 Travel Reimbursement policy and 302.0 Driver Requirements & Safety Guidelines.

Decision Making/Consequences of Error:

Decisions result in members either receiving or not receiving appropriate services or appropriate referrals for higher-level assistance as needed.

MHSU Care Manager

Position Description Summary:

The Mental Health/Substance Use MH/SU Care Manager is responsible for providing proactive intervention and coordination of care to eligible members identified as Special Health Care Needs, Complex Care Management or High-Risk High-Cost populations to ensure that these individuals receive appropriate assessment and services. The MHSU Care Manager works with the member and care team to alleviate inappropriate levels of care or care gaps through assessment, multidisciplinary team care planning, linkage and/or coordination of services across the MH/SU/IDD and other healthcare network(s) with existing or new care team members. MHSU Care Managers support and may provide clinical transition planning assistance to local hospitals and tracks individuals discharged from state and community hospitals to ensure they follow up with aftercare services and receive needed assistance to prevent further hospitalization. This is a mobile position with work done in a variety of locations. The MHSU Care Manager may work with members in their home communities. The MHSU Care Managers also works with other company staff, members and family members, providers as well as community stakeholders. Essential job functions of the MHSU Care Managers include, but may not be limited to:

• CM Platform basics
• Outreach & Engagement
• Release of Information practices
• Health Risk Assessment
• Medication List and Continuity of Care process
• Care Planning
• Interdisciplinary Care Team and Ongoing Care Management

Note: This position requires access to and use of confidential healthcare information or protected health information (PHI) as described in laws addressing patient confidentiality, including, but not limited to, the federal HIPAA law, the Confidentiality of Alcohol and Substance Abuse Patient Records law, 42 CFR Part 2, and various state laws. As such, the individual filling this position shall be required to be trained regarding such laws and shall be required to observe those laws in his/her capacity as an employee of Vaya Health. The individual filling this position shall also sign a confidentiality statement as an employee of the company.

Essential Duties and Responsibilities: List in order of importance and Percentages equal to 100%

30 % Clinical Assessment:

MHSU Care Manager meets with members to conduct a comprehensive bio-psycho-social assessment in order to gather information on their overall health, including behavioral health, developmental, medical, and social needs. The Health Risk Assessment (HRA) encompasses a comprehensive assessment addressing social determinants of health, mental health history and needs, physical health history and needs, intellectual/developmental disabilities, activities of daily living, access to resources, and other areas to ensure a whole-person approach to care. MHSU Care Manager may administer the PHQ-9, GAD, CRAFFT, ACES, LOCUS/ CALOCUS, and other assessments based on member’s clinical needs and scores are calculated and reviewed allowing MHSU CM to provide specific education and self-management strategies as well as linkage to appropriate therapeutic support. The assessment process includes reviewing and transcribing members’ current medication and entering into Company's Care Management platform to ensure the medication aspects of the member's health and care are addressed according to Company procedures.

The MHSU Care Manager uses the assessment to learn about the member's needs to assist the member and their team in planning for their care, prioritizing goals that to help them live the life they want in the community of their choice. MHSU Care Managers ensure members of the care team are involved in the assessment as indicated by the member and that other available clinical information is reviewed and incorporated into the assessment as necessary.

MHSU Care Managers are also responsible to review clinical assessments conducted by providers to ensure all areas of the member’s needs are addressed.

Assessments are completed at least annually, and anytime there is a significant life change or as indicated in Company policy.

40% Care Planning & Interdisciplinary Care Team

MHSU Care Managers use the assessment to create a person-centered care plan for members to help define what is important to members for their health. Care Plans are created based on information collected in the assessment process. MHSU CM assists members in refining and formulating treatment goals, identifying interventions, measurements, and barriers to the goals. MHSU CM works in an integrated care team including an RN and pharmacist along with the member to address needs and goals in the most effective way. MHSU CM and members solicit input from the care team and monitor progress. MHSU Care Managers ensure Care Plans include specific services to address mental health, substance use or intellectual/developmental disability, medical and social needs as well as personal goals.

MHSU Care Managers work with members and care teams to ensure care plans are developed at least once a year or anytime there is a significant life change.

MHSU Care Managers ensure that members/guardians have the opportunity to decide who they want at the care team meeting and coordinates and may facilitate the team meeting where member Care Plan is discussed and reviewed. The MHSU Care Manager ensures that the assessment, care plan and other relevant information is provided to the care team as indicated in Company policy.

Other elements of Care Planning include:

· Risk Management- Proactively ensures that individuals identified as a Special Needs enrollee that have treatment needs or require regular monitoring have a Behavioral Health Clinical Home and a Medical Home.

· Ensures that a Person-Centered Plan (PCP) is developed by a Behavioral Health Clinical Home or, if necessary, by the Care Manager to meet urgent needs and to access care for the individual.

· Executes skills in Motivational Interviewing (MI), as well as Screening, Brief Intervention, and Referral to Treatment (SBIRT), Solutions-Focused Brief interventions.

· Identifies gaps in services and intervenes to ensure that the individual receives appropriate care.

· Measures results of intervention and treatment, including reduction in high-risk events and inappropriate service utilization.

· Ensures that services for the individual are coordinated across the Company system and with other systems, including primary care.

· Provides clinical discharge planning assistance to local hospitals and tracks individuals discharged from state and local hospitals to ensure they follow up with aftercare services and receive needed assistance to prevent further hospitalization.

· Crisis planning with member and care team. MHSU Care Managers create a care management crisis plan which is separate but complimentary to the behavioral health provider’s crisis plan. MHSU CM collaborates with members to develop a Crisis Plan that is tailored to their needs and desires. The MHSU Care Manager ensures the crisis plan includes problem definition, physical/cognitive limitations, health risks/concerns, medication alerts, baseline functioning, signs/symptoms of crisis (triggers), de-escalation techniques. Provide crisis intervention, coordination, and care management if needed while with members in the community.

25% Collaboration:

Serves as a collaborative partner in identifying system barriers through work with community stakeholders. Manages and facilitates Child/Adult High-Risk Team meetings in collaboration with DSS, DJJ, CCNC, school systems, and other community stakeholders as appropriate. Works in partnership with other Vaya departments to address identified needs within the catchment. MHSU CM may participate in cross-functional clinical and non-clinical meetings and other projects to support the department and organization. Participate in routine multidisciplinary huddles including RN, Pharmacist, M.D. to present complex clinical case presentation and needs, providing support to other CCM’s and receiving support and feedback regarding CCM interventions for clients’ medical, behavioral health, intellectual /developmental disability, medication, and other needs. MHSU CM participates in other high-risk multidisciplinary complex case staffing as needed to include Company Medical Director, Utilization Management, Provider Network, and Complex Care Management leadership to address barriers, identify need for specialized services to meet client needs within or outside the current behavioral health system.

5%

Other duties as assigned.

Supervisory Responsibilities:

N/A

Requirements:

Education and Experience:

Master’s Degree in Human Service-related field (such as Psychology, Social Work, etc.) is required, along with at least two years of post-degree progressive experience providing similar services to the population served. Additionally, valid licensure or certification in profession (social work, counseling, or psychology) is required.

Mental/Physical Demands:

Person in this position is required to have close visual acuity to perform activities that include viewing a computer terminal; and extensive reading. Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists, and fingers. Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.

Knowledge, Skills and Abilities:

Employee will participate in and maintain Care Management and Company trainings and proficiencies as required.

A high level of diplomacy and discretion is required to effectively negotiate and resolve issues with minimal assistance. This will require exceptional interpersonal skills, highly effective communication ability, and the propensity to make prompt independent decisions based upon relevant facts. Problem-solving, negotiation, arbitration and conflict resolution skills are essential to balance the needs of both internal and external customers. Must be highly skilled at shifting between macro and micro level planning, maintaining both the big picture, and seeing that the details are covered.

MH/SU Care Managers must exhibit an extensive understanding of the Diagnostic and Statistical Manual of Mental Disorders (current version) and have considerable knowledge of the MH/SU/DD service array provided through the network of Vaya providers. Additional knowledge in Vaya Medicaid B and C waivers and accreditation is essential.

The employee must be detail-oriented, able to organize multiple tasks and priorities, and to effectively manage projects from start to finish. Work activities quickly change according to mandated changes and changing priorities within the department. The employee must be able to change the focus of his/her activities to meet changing priorities.

Training, learning, and proficiency are tracked through the Care Management Training Matrix and any other required means. Training may be delivered in a variety of methods and forums. MHSU Care Managers must understand the following areas, in addition to other required trainings:

· BH I/DD Tailored Plan eligibility and services

· Whole-person health and unmet resource needs (ACEs, Trauma, cultural humility)

· Community integration (Independent living skills; transition and diversion, supportive housing, employment, etc.)

· Components of Health Home Care Management (Health Home overview, working in a multidisciplinary care team, etc.)

· Health promotion (Common physical comorbidities, self-management, use of IT, care planning, ongoing coordination)

· Other care management skills (Transitional care management, motivational interviewing, Person-centered needs assessment and care planning, etc.)

· Serving members with I/DD or TBI (Understanding various I/DD and TBI diagnoses, HCBS, Accessing assistive technologies, etc.)

· Serving children (Child- and family-centered teams, Understanding of the “System of Care” approach)

· Serving pregnant and postpartum women with SUD or with SUD history

· Serving members with LTSS needs (Coordinating with supported employment resources

MHSU Care Managers should be proficient in the aforementioned essential job functions. Job functions with higher consequences of error may be identified, and proficiency demonstrated and measured through job simulation exercises administered by the supervisor where a minimum threshold is required of the position.

In addition, MHSU CM must have a thorough knowledge of standard office practices, procedures, equipment, and techniques and have intermediate to advanced proficiency in Microsoft office products (Word, Excel, Power Point, Outlook, Teams, etc.)

Licensure:

Valid licensure or certification in profession (social work, counseling, or psychology) is required.

Certifications

N/A

Driving on Company Business:

This position requires driving a personal vehicle for Company Business in accordance with 2995 Expense Reimbursement policy and 2498 Driving on Company Business.

Decision Making/Consequences of Error:

Decisions result in clients either receiving or not receiving appropriate Services or appropriate referrals for higher-level assistance as needed.

American’s with Disabilities Act (ADA):

A request for accommodation under the American’s with Disabilities Act (ADA) can be discussed with Human Resources and the process for ADA can be found in Policy 2973 Americans with Disabilities Act.

• In cooperation with Hospital Emergency Department or Inpatient Discharge planning teams, participate in developing transition plans, educating staff and members regarding network services and supports with consideration of medical necessity, funding eligibility and appropriateness of recommendations relative to person-centered, recovery principles and known best/appropriate practice.
• Develop, coordinate and link emergency discharge services (up to and including residential placement based on medical necessity, funding, and service definitions or EPSDT for children/youth) for members who are inappropriately discharged from residential facilities (child or adult); coordination with FastTrack process; notifying Company Network of provider contractual concerns or through established process if quality of care or health and safety concerns;
• Notification and update of assigned community-based Care Manager (CM) if member is currently assigned;
• Transition to community-based CM post-discharge;
• Participate in the development and implementation of best practice complex care strategies as identified by Company;
• Provide proactive and clear supervision supported by data to ensure supervisors and teams are meeting departmental and organizational benchmarks; and
• Collaborate with key stakeholders, network providers and non-network providers with particular attention to crisis, inpatient, 3-way bed contracts, NC START, etc.

• Proactively ensures that members identified as eligible for Company CM that have treatment needs or require regular monitoring have Behavioral Health services and supports and linked, at a minimum, to primary care.
• Ensures that the care plan includes a transition plan and ensure it is developed by care team or, if necessary, by the Acute Response CM to meet needs and to access care for the individual.
• Convenes key providers and others to address needs of the individual, ideally in person or telephonically while member is still in facility.
• Identifies gaps in services and supports, intervenes to ensure that the member receives appropriate care and can access that care.
• Measures results of intervention and treatment, including reduction a high-risk events and inappropriate service utilization.
• Ensures that services are coordinated across the Company system and with other systems, including primary care.
• Provides clinical transition planning assistance to local hospitals, and coordinates with hospital liaisons when applicable, and tracks members discharged from state and local hospitals to ensure they follow up with aftercare services and receive needed assistance to prevent further hospitalizations.

• CM Platform basics
• Outreach & Engagement
• Release of Information practices
• Health Risk Assessment
• Medication List and Continuity of Care process
• Care Planning
• Interdisciplinary Care Team and Ongoing Care Management

Mental/Physical Demands: 

• BH I/DD Tailored Plan eligibility and services
• Whole-person health and unmet resource needs (ACEs, Trauma, cultural humility)
• Community integration (Independent living skills; transition and diversion, supportive housing, employment, etc.)
• Components of Health Home Care Management (Health Home overview, working in a multidisciplinary care team, etc.)
• Health promotion (Common physical comorbidities, self-management, use of IT, care planning, ongoing coordination)
• Other care management skills (Transitional care management, motivational interviewing, Person-centered needs assessment and care planning, etc.)
• Serving members with I/DD or TBI (Understanding various I/DD and TBI diagnoses, HCBS, Accessing assistive technologies, etc.)
• Serving children (Child- and family-centered teams, Understanding of the “System of Care” approach)
• Serving pregnant and postpartum women with SUD or with SUD history
• Serving members with LTSS needs (Coordinating with supported employment resources

R.N., House Supervisor

We are seeking House Supervisors to join our team! Staff functioning as a House Supervisor will provide administrative supervision in the workflow, resource utilization, and bed management for assigned clinical and non-clinical departments. Successful candidates will demonstrate the ability to support the psychological and physical support of patients, visitors, and coworkers. This would include responding to organizational emergency situations, initiating disaster notification processes, handling patient placement on both campuses and, would escalate assistance as appropriate. House Supervisors will be responsible for understanding the resources needed to resolve problems, and when to use them in order to facilitate organizational operations.    

What You'll Need:    

• Current Colorado Registered Nurse Licensure.    
• A Bachelor of Science in Nursing (BSN) is required. Candidates with a degree in progress, or who make a commitment to begin within 6 months of hire may also be considered.    
• High level of critical decision-making ability.    
• BLS, ALS, PALS, and Neonatal Resuscitation certifications.     
• At least 2 years of experience in an acute care setting is preferred.    

What You'll Do:     

• Strong understanding of nursing in accordance with law, policies, procedures, and standard practices.    
• Assess and interpret overall staffing effectiveness for the appropriate number, competency, and skill mix in the provision of health care services according to census, acuity, and responsible use of labor budget.     
• Serve as a professional resource to patients, families, providers, and staff by prioritizing, mediating, and resolving concerns.     
• Maintain nursing standard of care and assist with writing and updating policies and procedures.    
• Demonstrates an expectation for support and quality improvement through quality metrics.     
• Ability to build rapport and coordinate team problem-solving methods.    
• Act as a liaison with administrative and facility directors.     

We Take Care of Our People

As the largest employer in the San Luis Valley, we strive to provide our employees with high-quality, robust benefits to balance great work with a great life.  To show our appreciation of your hard work, we offer the following benefits and perks:

• Medical, dental and vision plans to suit the needs of you, your family, and lifestyle.
• Paid Time Off and Sick Leave programs.
• Free life insurance benefits for full-time employees with the opportunity for eligible employees to purchase additional coverage.
• Education program to foster your growth and development.
• Opportunities to volunteer and give back to the community.
• Cell phone discounts, ski/snowboard lift ticket discounts, Dell Computer discounts, local pool discounts, gym discounts, and more!
• On-site employee workout center.

Registered Nurse, Float Pool

We're seeking Registered Nurses to join our Float Pool! Individuals in this role will provide nursing care to all patients in the assigned unit, demonstrating the ability to triage and assess patient needs to ensure adequate care and nursing standards are met, observes and initiates appropriate nursing treatments, and reports symptoms and conditions of patients to treating providers.  Additional tasks include assisting providers with invasive procedures, administering medications, documenting, and assisting other staff members as required to ensure quality care is provided to all patients.  

A sign-on bonus/ relocation assistance is available for the selected qualified candidate.

What You'll Need:   

• Current Colorado Registered Nurse license  
• Certifications in Basic Life Support, Advanced Life Support, Pediatric Advanced Life Support, Neonatal Resuscitation Program. 
• Two years of nursing experience

What You'll Do:   

• Assisting, planning, implementing and evaluating the delivery of care to accepted nursing and hospital standards  
• Administering prescribed medications and treatments in accordance with approved nursing techniques.  
• Maintaining awareness of comfort and safety needs of patient.  
• Observing patient, records significant conditions and reactions, and notifies physician of patient's condition and reaction to drugs, treatments, and significant incidents.  
• Responding to all situations based upon nursing standards, policies, procedures, and protocol.  
• Documenting nursing history and physical assessment for assigned patients.  

We Take Care of Our People

As the largest employer in the San Luis Valley, we strive to provide our employees with high-quality, robust benefits to balance great work with a great life.  To show our appreciation of your hard work we offer the following benefits and perks:

• Medical, dental and vision plans to suit the needs of you, your family, and lifestyle.
• Paid Time Off and Sick Leave programs.
• Free life insurance benefits for full-time employees with the opportunity for eligible employees to purchase additional coverage.
• Education program to foster your growth and development.
• Opportunities to volunteer and give back to the community.
• Cell phone discounts, ski/snowboard lift ticket discounts, Dell Computer discounts, local pool discounts, gym discounts, and more!
• On-site employee workout center.