Nurse Manager, Care Management
3 weeks ago
A New York City-based health services network is currently seeking an experienced licensed Registered Nurse (RN) to join their growing team in Manhattan as their new Nurse Manager, Care Management (RN). In this role, the Nurse Manager, Care Management (RN) will be responsible for managing the daily activities of the Medicare team to ensure quality outcomes in the delivery of member-centered case management, including reduction in emergency room visits and hospital admissions, improved member satisfaction, improved member health, and cost effectiveness.
About the Opportunity:
- Setting: Managed Care
- Patient Population: Adults & Geriatrics
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
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