RN Case Manager Team Lead

4 weeks ago

Charleston, West Virginia, United States CommuniCare Family of Companies Full time
Job Summary

The Personalized Health Partners (PHP) RN Case Manager Team Lead is responsible for overseeing the delivery of RN case management services, clinical and administrative support, and support to nurse practitioners.

Key Responsibilities
  • Oversight of RN case management services, clinical and administrative support, and support to nurse practitioners
  • Identify opportunities and resources to improve clinical and quality outcomes
  • Anticipate education opportunities for RN case management team
  • Document in accordance to program expectations and compliance standards
  • Consistent delivery on obligations and promises is required
  • Abides to all HIPPA laws and observes confidentiality policy at all times and abides to all policies and procedures
  • Utilize data resources to identify closure of quality and documentation gaps
  • Develop relationships with key stakeholders within Medical Practice, Nursing Facilities, Corporate Leadership, and health plan partners
  • Adhere to all quality assurance initiatives and provisions
  • Coordinate and/or attend regular conference calls with appropriate teams as practice deems necessary
Requirements
  • Bachelor of Science in Nursing degree
  • Active, unrestricted state license/s
  • Ability to obtain licensure in additional states in service area as requested (telehealth providers required to be licensed in OH, IN, WV, MD, VA, PA)
  • US work authorization
  • 2+ years clinical experience as a Nurse in geriatric, adult or family practice setting
  • Ability to work in a flexible environment and schedule
  • Passionate about providing healthcare to the senior and low-income populations
Preferred Qualifications
  • 1+ years clinical management experience as a Nurse in geriatric, adult or family practice setting
  • Training or clinical experience in geriatrics
  • 1+ years clinical experience as a RN Case Manager
  • Experience or training working in a metrics, results driven healthcare model
  • Be open to professional development through training, obtaining certifications if necessary, and attending team meetings
  • Experience working in value-based care models
  • Training or experience in geriatric, assisted living, and/or skilled nursing setting
  • Experience working in a collaborative healthcare setting to drive positive outcomes and achieve goals
  • Training or experience in outpatient primary care setting

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