Manager, Care Management
4 weeks ago
It's rewarding to be on a team of people that truly believe in making an impact We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.Job SummaryThe Regional Manager of Care Management will oversee a team a care management coordinators in a given region and/or market to ensure provision of high-quality health care services including; comprehensive care management, care coordination, health promotion, transition of care, referral to community and social support services, and the use of Health Information Technology. The Regional Manager of Care Management will serve as a backup for care management coordinators who are on any type of extended leave or when there is a vacancy. This position will work collaboratively with other departments to meet program goals, performance targets, and ensure the organization is well managed in its entirety.Essential Duties & ResponsibilitiesResponsible for providing support and direct supervision to Care Management CoordinatorsResponsible for in hiring, scheduling, evaluating, ongoing staff development, team meetings, and individual supervisory meetings.Train and develop new and existing care managers in care management activities, current protocols, and policies.Manages and assigns care managers case loadMonitor and develop reports on care managers' productivityReviews care management documentation to ensure care managers are providing a person-centered approach and addressing barriers to careDevelop and support staff learning and processional development goals; ensure assigned staff completes required trainingAssist with periodic audits to monitor quality indicators and ensure performance metrics are being met.Provide on-call support as scheduledParticipate and facilitate in staff, team, and vendor meetingsAssist with departmental initiatives and implementation of new programs as they relate to Care Management and Cano at Home.Perform all other duties relevant to the position as requested.Monitor and track effectiveness of program performance to monitor success of key performance indicatorsSupport the Director to identify areas of non-compliance and assure implementation of corrective action plans to address deficiencies in regions.Supervisory ResponsibilitiesProvide supervision and support to the Care Management Coordinators, including performance management and adherence to team policies, processes and workflows.Critical ResultsCR #1: > 80% TOC completion for patients post dischargeCare Managers will complete > 80% of TOC cases in MDFlow for patients post discharge.CR #2: > 85% MRP completion for patients post dischargeCare Managers will complete > 80% of TOC cases in MDFlow for patients post discharge.CR #3: Care Management Implementation and/or IntegrationSuccessful implementation and integration of Care Management staff and workflows in new/acquired centers within the first 180 days.Best PracticesMonitor team performance through on-going evaluation and tracking of performance metrics as they relate to TOC cases created in the Care Management platform.Monitor team performance through on-going evaluation and tracking of performance metrics as they relate to MRP completion by analyzing health plan gap reports monthly.Identify adverse trends with TOC and MRP to proactively implement effective strategies that address areas for performance improvement with care managers not meeting performance metricsAnalyze data from Care Management Platform and Health Plan census to ensure outcomes are aligned with TOC and MRP metricsProvide input into the annual review of policies and procedures, the CM program results and outcomes, and future program goals and interventionsOversee Care Managers productivity and ensure results are aligned with metrics and deadlines.Evaluate findings prioritized for resolution and/or improvement, develop appropriate strategies and measure for effectivenessSupport training for current and/or new acquisition staff to apply the correct workflows in order to effectively achieve department and organizational metrics.Education & ExperienceRequires a bachelor's degree with two years of relevant experience ANDA license as a Registered Nurse with two years of relevant experience, which can include any employment experience and is not limited to case management/service coordination duties.Managed Care experience preferred.Bi-lingual: English and Spanish requiredKnowledge, Skills & ProficienciesAdvanced skills with Microsoft Office requiredExcellent organizational, interpersonal, and verbal and written communication skills required; anility to attend to detail, organize tasks/priorities and complete with accuracyAbility to pay close attention to detail and to ensure accuracy of reports and data.Critical thinking, creativity, and flexibility with an ability to adapt to various and fast paced environmentsExceptional interpersonal skills with ability to interface effectively both internally and externally with a wide range of people including physicians, office staff and other health plan staffAbility to act quickly, assess and act accordingly in crisis situationsSkill in operating phones, personal computer, software, and other IT systems.Physical RequirementsThis position works under usual office conditions. The employee is required to work at a personal computer as well as be on the phone for extended periods of time. Must be able to stand, sit, walk and occasionally climb. The incumbent must be able to work extended and flexible hours and weekends as needed. Physical demands include ability to lift up to 50 lbs. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Travel RequirementsAmount of Expected TravelDetailsWork will involve some driving/traveling to assigned clinics.DisclaimerThe duties and responsibilities described above are designed to indicate the general nature and level of work performed by associates within this classification. It is not designed to contain, or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of associates assigned to this job. This is not an all-inclusive job description; therefore, management has the right to assign or reassign schedules, duties, and responsibilities to this job at any time. Cano Health is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.Join our team that is making a differencePlease see Cano Health's Notice of E-Verify Participation and the Right to Work post here
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