Care Manager, CMHN MSSP ACO Care Management Program

North Carolina Community Health Center Association; Raleigh (NC); Vor Ort; USD 90.000 - 130.000; Vollzeit

Zusammenfassung

North Carolina Community Health Center Association seeks a Care Manager for its CMHN MSSP ACO Care Management Program. The role leads design, implementation, and optimization of Medicare care management services to improve quality, reduce costs, and enhance patient experience across participating centers.

Collaborating with the Chief Medical Officer and VP Care Management, this position shapes the clinical and operational infrastructure, supports policy development, and drives program

Qualifikationen

• RN license in NC with nursing degree(s).
• 3+ years in care management, case management, or care coordination for safety-net populations.
• CCM certification preferred; willingness to complete within 12 months.
• Experience with MSSP or value-based care models is preferred.
• Supervisory or managerial experience preferred, not required.
• Up to date immunizations as listed (Hepatitis B, MMR, Varicella, Tdap, TB, Flu, BLS).

Aufgaben

• Design, implement, and optimize the CMHN MSSP ACO Care Management Program.
• Develop policies, procedures, clinical workflows, and care management strategies.
• Create quality dashboards, reporting, and documentation standards.
• Recruit, onboard, supervise, and develop care managers and coordinators as the program grows.

Kenntnisse

Communication skills

MS Office proficiency

Time management

Attention to accuracy

Ausbildung

Associate degree or better from an accredited School of Nursing

BSN preferred

Jobbeschreibung

The Care Manager, CMHN MSSP ACO Care Management Program, is responsible for the design, implementation, and ongoing optimization of the Carolina Medical Home Network (CMHN) Medicare Shared Savings Program (MSSP) ACO Care Management Program. This position will support the development and operationalization of Medicare care management services that support participating health centers in improving quality outcomes, reducing total cost of care, enhancing patient experience, and supporting sustainable care management delivery.

Working collaboratively with the Chief Medical Officer, Vice President of Care Management and Provider Network Support, participating health centers, and organizational partners, this individual will help evaluate, develop, implement, and optimize the clinical and operational infrastructure for Medicare care management services, which may include Chronic Care Management (CCM), Advanced Primary Care Management (APCM), Transitional Care Management (TCM), Principal Care Management (PCM), Remote Patient Monitoring (RPM), Behavioral Health Integration (BHI), Collaborative Care Model (CoCM), and other appropriate services. Responsibilities may include development and implementation of policies and procedures, clinical workflows, implementation strategies, quality assurance processes, performance dashboards, reporting, documentation standards, staff training, and program evaluation, in coordination with internal teams and external partners as applicable. The care management delivery model is still being determined and may include services delivered by CMHN staff, services delivered through an external vendor, or a hybrid approach. This role requires flexibility, as responsibilities may shift among direct patient care, process and workflow development, and coordination with external partners as the model is defined and the program evolves.

This position serves as a key clinical and operational resource for Medicare care management within the MSSP ACO and works in close collaboration with CMHN's existing Medicaid care management programs to ensure alignment while maintaining distinct program objectives, workflows, and regulatory requirements. As the program grows, this individual will support recruitment, onboarding, supervision, and professional development of care managers and care coordinators while fostering strong partnerships with participating health centers to ensure successful implementation and long‑term sustainability.

Minimum Qualifications (Degrees/Certificates):

• Associate degree or better from an accredited School of Nursing; Bachelor of Science in Nursing (BSN) preferred.
• Licensed as a Registered Nurse (RN) with the state of NC.
• At least three years of experience providing care management, case management, or care coordination to a safety-net population.
• Experience working with Medicare populations or value-based care models preferred.
• Experience leading projects, implementing workflows, or supporting program development preferred.
• Certified Case Manager (CCM) Preferred/Willingness to complete within one year of starting position.
• Experience with accountable care organizations, Medicare Shared Savings Program (MSSP), Medicare populations, or other value-based care models preferred.
• Supervisory or managerial experience preferred, not required.
• Up to Date on required immunizations (See list below)
  • Hepatitis B
  • MMR
  • Varicella
  • Tdap
  • TB skin test
  • Flu vaccine (annually)
  • BLS (CPR)

Knowledge, Skills, and Abilities:

• Excellent and effective written and oral communication skills.
• Proficiency in Microsoft Office Outlook, Word, Excel, PowerPoint use, and e‑mail communication.
• Ability to communicate clearly and succinctly.
• Dependable, manages time well; efficient and organized.
• Ability to produce accurate