Clinical Program Manager, Care Management Support Services

Description

The Clinical Program Manager, Care Management Support Services is responsible for Care Management Support Services (CMSS) client and CMSS vendor relationship.

This includes oversight of implementation, onboarding, and management of clients participating in Chronic Care Management, Remote Patient Monitoring, Behavioral Health Integration, and / or Annual Wellness with NextGen Healthcare Managed Service Program.

• Oversight of implementation, onboarding, and management of clients participating in Chronic Care Management, Remote Patient Monitoring, Behavioral Health Integration, and / or Annual Wellness with NextGen Healthcare Managed Service Program.
• Oversight and vendor management responsible for the clinical care and in accordance with Centers for Medicare and Medicaid Services (CMS).

This includes but is not limited to review of clinical protocols, patient consent, device assignment, patient enrollment an discharges.

• Vendor management and delivery of contracted scope of services includes communication with clients, coordination of services with the vendor and internal departments, establishing and maintaining policy and procedures, and vendor performance expectations.
• Provide experienced Revenue Cycle Management expertise with consultative approach toward process improvement; meet with client contacts as needed.
• Manage client relationships for strategic accounts.
• Ensure service level agreements are met for each client, identify opportunities for improvement and develop action plans for problem resolution.
• Evaluate effectiveness of programs and services.
• Coordinate internal service teams, working with partners to reduce recurring errors, identify needs for resource changes, including but not limited to sales, training and implementation, solutions, account management, outsourced vendor relationships, IT and other divisions.

Focus on maintaining and improving efficiency, effectiveness, and quality of services.

• Manage and drive staffing plans, schedules, quality initiatives, performance levels, and process change initiatives.
• Identify opportunities for referrals, references, and case studies.
• Perform other duties that support the overall objective of the position.

Education Required :

• Bachelor’s Degree in Business Administration, Health Management Information Systems, or related discipline.
• Or, any combination of education and experience which would provide the required qualifications for the position.

Experience Required :

• 10+ years experience in Revenue Cycle Management
• 5-7 years in Internal Medicine, Chronic Care Management or working with chronically ill patients.
• Vendor Management

License / Certification Required :

Active Clinical License (BSN / RN / LVN / LPN).

Knowledge, Skills & Abilities :

• Knowledge of : Customer support / success / relationship operations and vendor management best practices.
• Skill in : Leadership, communication, collaboration, strategic and tactical thinking, analytical, problem solving, customer service and interpersonal skills.
• Ability to : Maintain confidentiality, analyze situations accurately and take effective action. Develop strong vendor and client relationships and deliver client-centric solutions;

develop effective solutions and strategies. Develop and maintain effective working relationships through collaboration and respect.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee's ability to perform the position described.

It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

This document does not represent a contract of employment, and the company reserves the right to change this job description and / or assign tasks for the employee to perform, as the company may deem appropriate.

NextGen Healthcare is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.