Manager Nursing - LTSS Care Management/ NY License Required (Remote)

EmblemHealth; New York (NY); Remote; USD 77,000 - 150,000; Full time

Job summary

A leading healthcare organization is seeking a Care Management Team Manager to oversee daily operations and performance of the care management team. The role involves coaching team members, monitoring performance metrics, and ensuring compliance with regulatory standards. Ideal candidates will have a Bachelor's degree in Nursing, relevant licenses, and extensive clinical experience.

Qualifications

• Bachelor's degree, preferably in Nursing.
• Current New York State RN or LSCSW license.
• 5 - 8+ years of clinical experience.

Responsibilities

• Manage daily operations of the Care Management team.
• Train employees and complete quarterly evaluations.
• Monitor team caseloads and documentation.

Skills

Analytical skills

Problem-solving skills

Communication skills

Detail oriented

Organizational skills

Education

Bachelor's degree in Nursing

Tools

MS Office

Job description

Summary of Job

Responsible for the day-to-day operation and performance of the care management team providing care management services to EmblemHealth members. Utilize data to monitor team member performance (quality, outcome and productivity measures, etc.); deploy strategies to improve performance. Provide coaching and mentoring to team members to address performance related issues. Use problem solving abilities to create solutions to operational and clinical issues identified during day-to-day operations. Collaborate with the Director and AVP of Care Management and internal audit teams to address audit related findings and implement performance improvement strategies. Develop job aides, work flows and other tools to enhance delivery of care management services. Collaborate with other functional areas within organization to ensure that Care Managers are implementing EmblemHealth Health Plans policies, procedures and all regulatory mandates, consistent with Emblem Health Plans mission, vision, purpose
and value statement.

Responsibilities

• Manage daily operations of the Care Management team including measurement of performance metrics and productivity standards; implement, deploy, and reinforce strategies to improve performance.


• Train employees in process operations; act as a preceptor to newly hired staff.


• Complete quarterly evaluations of staff as needed.


• Monitor team caseloads; shift workloads accordingly to meet departmental/organizational needs.


• Monitor timeliness and appropriateness of documentation in clinical systems to ensure that documentation meets accreditation and regulatory standards.


• Ensure that team members are managing enrollees across the care continuum, inclusive of behavioral health, so that enrollees have access to needed care and services.


• Serve as a clinical resource; attend Care Management rounds.


• Monitor employees' performance regularly and coach employees as needed.


• Perform other related tasks as directed or required.

Qualifications

• Bachelor's degree, preferably in Nursing (Required)


• Current New York State RN or LSCSW license (Required)


• CCM certification (Preferred)


• 5 - 8+ years of clinical experience (Required)


• Health plan experience (Preferred)


• May be required to manage Long-Term Services and Supports (LTSS) cases (Preferred)


• Experience leading care management teams (Required)


• Detail oriented; strong analytical and problem-solving skills; ability to execute on strategy (Required)


• Ability to organize, prioritize, and effectively manage multiple tasks with competing priority levels and deadlines (Required)


• Excellent communication skills (verbal, written, presentation, interpersonal) with all types/levels of audiences (Required)


• Proficient with MS Office - Word, Excel, PowerPoint, Outlook, Teams, etc. (Required)


• Able to analyze problems and recommend and deploy strategies to improve performance in collaboration with the leadership team (Required)

Additional Information

• Requisition ID: 1000002386


• Hiring Range: $77,760-$149,040