Remote - Value Based Clinical Care Team Manager

Job Description

Job Description

Company Description

WHO IS GUIDEHEALTH?

Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers.

Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers.

Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.

Job Description

The Value Based Clinical Care Team Manager is primarily responsible for the day-to-day operations of an integrated multi-disciplinary clinical and clinical support structure that will effectively monitor, support, and lead Value Based clinical initiatives.

This includes but is not limited to case management, transitions of care, care coordination and continuity, provider / staff education on ACO / MA Plan clinical programs, and helping to build and maintain a network of community support.

This individual must exhibit strong leadership, management, and interpersonal skills, as well as the ability to utilize both internal and external resources to accomplish the goals and objectives of the organization.

WHAT YOU’LL BE DOING

• Effectively manage day to day ACO / MA Plan Clinical Programs to enhance clinical efficiencies
• Identify opportunities for increased outpatient vs. inpatient utilization
• Utilizes data provided to help in managing population health needs and implements population programs for ACO / MA Plan beneficiaries
• Execute case management for patients identified at highest risk for adverse event or exacerbation having ability to impact, with goal of decreasing unnecessary emergency department visits / hospitalizations
• Oversee extended patient care team including but not limited to : Social Workers, Emergency Department Liaisons, Behavioral Health Liaisons, and Home Health Liaisons.
• Oversee smooth Transitional Care Management for all patients discharged from in patient facility (hospital, skilled nursing / rehab, behavioral health) ensuring : Primary Care Provider visit, DME and Home Health Services, Specialist appointments, and community resources / social services are provided as indicated.
• Ensure Quality Measures are reviewed and addressed when applicable / appropriate
• Implement and direct ACO / MA Plan Health Education Activities for beneficiaries, providers, and staff
• Participate in Care Coordination and Quality Committees, Primary Care Provider Meetings, JOC Meetings, and other meetings as required
• Monitor corporate initiatives and strategies to achieve utilization of business and financial goals
• Manage the successful integration of ACO Programs into current operations to meet the goals of all stakeholders
• Maintain collaborative relationships with business partners both within the company and the community
• Manage and execute organizational opportunities and implement changes that are in alignment with corporate financial goals and strategic endeavors.

Qualifications

WHAT YOU'LL NEED TO HAVE

• RN / BSN required
• 5 years of management experience
• 4 years clinical nursing experience
• At least 4 years of extensive experience in chronic care case management in outpatient setting
• Certification in case management preferred
• Must be able to work remotely in Georgia, Pennsylvania, and Texas
• Must feel comfortable and confident leading a team of certified but unlicensed personnel and Registered Nurse case managers
• Ability to read, analyze, and interpret the most complex documents. Ability to respond effectively to the most sensitive inquiries or complaints.

Additional Information

Certificates, Licenses, Registrations

Registered Nurse Preferred

COMPENSATION

The base pay range for this role is $105K per year paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to : skill set, years of relevant experience, education, location, and licensure / certifications.

COMPENSATION :

The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to : skill set, years of relevant experience, education, location, and licensure / certifications.

OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT

Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances.

Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.

OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA

This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties.

For any security-specific roles, the responsibilities would be further defined by the hiring manager.