Responsibilities
The Nurse Manager, Care Management (RN) will :
- Provide clinical guidance and supervision to assigned Care Managers and clinical support staff to promote efficient and effective delivery of care management services
- Supervise day to day activities to make certain that case management services are provided
- Supervise the entire care management workflow including case referrals, assignments, interventions and goal setting, follow-up / follow-through activities, documentations, and escalations
- Ensure care management activities are conducted in a safe, efficient, and effective manner to promote continuity and quality of care
- Review, develop and modify day to day workflows to ensure timely follow up
- Perform ongoing quality review of cases to ensure accuracy and compliance
- Evaluate and document staff performance; coach staff to improve both quality and quantity of skills attaining optimal performances
- Resolve issues and mitigate conflict encountered during daily operations, appropriately escalate issues to the Director of Medicare
- Identify and report potential risk, operational opportunities, and barriers encountered
- Conduct monthly audits for the purpose of departmental / organizational reporting and providing formal feedback to case management staff
- Create and submit operational weekly / monthly / quarterly reports
- Work with the leadership team to develop and implement ongoing training and development efforts
- Perform other duties, as needed
Qualifications :
- 5+ years of Care Management experience in a Healthcare and / or Managed Care setting
- Bachelor's Degree in Nursing
- NYS Registered Nurse (RN) license
- Managerial and / or Leadership experience in a Healthcare and / or Managed Care setting
- Computer savvy
- Microsoft Office proficient (Word, Excel, and PowerPoint and Outlook)
Desired Skills :
- Master's Degree in Nursing
- Bilingual (English and Cantonese, Mandarin, or Spanish)
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