RN Manager Virtual Health Lead

4 weeks ago

Hartford, Connecticut, United States Highmark Health Full time
Job Summary

This role leads a team of Registered Nurse Complex Case Managers in delivering case management services to a specified panel of members with varying health statuses and clinical needs.

The RN Manager Virtual Health is accountable for daily unit operations, including staffing and scheduling, to ensure effective member outreach within defined timeframes and established processes.

This position ensures team members are clinically competent and adequately trained to achieve member engagement targets and defined clinical and financial outcomes.

Key Responsibilities
  • Establish and monitor individual and team performance goals, providing feedback and taking action to ensure goals are achieved.
  • Perform management responsibilities, including hiring and termination decisions, coaching and development, rewards and recognition, performance management, and staff productivity.
  • Plan, organize, staff, direct, and control daily department operations, developing and implementing policies and programs as necessary.
  • Assist in focusing activities toward a strategic direction, developing tactical plans, driving performance, and achieving targets in collaboration with the Director.
  • Ensure ongoing staff development through education and opportunities for professional development.
  • Review department performance in relation to established metrics and implement changes in collaboration with other multidisciplinary team managers to effect continual improvement in services provided.
  • Identify cost savings opportunities within the department and/or operations, in collaboration with the Director.
  • Ensure all services are delivered consistent with applicable internal policies and procedures, as well as applicable CMS, state, local, and regulatory agency requirements, and applicable standards of practice for case management.
Requirements
  • Bachelor's Degree in Nursing
  • 6 years of experience in the Healthcare field
  • Master's Degree in Nursing
  • 7 years of any combination of clinical and case management
  • ~3 years of management/supervisory or leading/working on project teams
  • Working with the healthcare needs of diverse populations
  • Excellent interpersonal and communication skills and the ability to work in a matrix management environment
  • Understanding of healthcare costs and the broader healthcare service delivery system
  • Strong analytic skills with ability to interpret, evaluate, and act on productivity, clinical, and financial data
  • Proficient computer skills, including Microsoft Office products
  • Proficiency in MS Excel and enhanced data and statistical analysis skills
  • Excellent interperson/consensus building skills as well as the ability to work with a variety of internal and external colleagues from all levels of an organization
  • Excellent organizational, time management, and project management skills
  • Demonstrated ability to handle multiple priorities in a fast-paced environment
  • Certification in Case Management
Language Requirement

English

Travel Requirement

Office-Based

Travels regularly from the office to various work sites or from site-to-site

Works primarily out-of-the office selling products/services (Sales employees) - Does Not Apply

This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.

In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law.

Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity

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For accommodation requests, please contact HR Services Online at .

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