Clinical Care Management Leader (RN)

EmblemHealth, Inc.; New York (NY); In loco; USD 78.000 - 149.000; Tempo pieno

Descrizione del lavoro

EmblemHealth is seeking a Clinical Leadership role to provide oversight of Care Managers and Community Health Workers serving members with complex medical, behavioral health, and social needs. You will direct daily care management operations, distribute caseloads, optimize workflows, ensure timely documentation, and maintain regulatory compliance.

The ideal candidate has a NY State RN license, 5–8+ years of clinical experience, CCM certification preferred, and strong analytical and communication

Competenze

• Bachelor’s degree required, preferably in Nursing.
• Current New York State RN license required.
• CCM certification preferred.
• 5–8+ years of clinical experience (Required).
• Experience leading care management teams (Required).
• Detail oriented; strong analytical and problem-solving skills; ability to execute on strategy (Required).
• Excellent communication skills (verbal, written, presentation, interpersonal) with all types of audiences (Required).
• Proficient with MS Office (Word, Excel, PowerPoint, Outlook, Teams, etc.) (Required).

Mansioni

• Provide clinical leadership and oversight to Care Managers and Community Health Workers serving members with complex medical, behavioral health, and social needs.
• Direct daily care management operations, including caseload distribution, workflow optimization, timely documentation, and management of high-risk, high-cost populations.
• Utilize data to monitor team member and program performance and deploy strategies to improve program efficiency and effectiveness.
• Ensure compliance with NCQA, CMS, state, accreditation, and organizational standards.
• Collaborate with utilization management, behavioral health, pharmacy, quality, and provider teams.

Conoscenze

Communication

Analytical ability

Problem solving

MS Office

Formazione

Bachelor’s degree

Strumenti

MS Office

N/A

Descrizione del lavoro

EmblemHealth is seeking a Clinical Leadership role to provide oversight of Care Managers and Community Health Workers serving members with complex medical, behavioral health, and social needs. You will direct daily care management operations, distribute caseloads, optimize workflows, ensure timely documentation, and maintain regulatory compliance.

The ideal candidate has a NY State RN license, 5–8+ years of clinical experience, CCM certification preferred, and strong analytical and communication