Supervisor of Coordinated Care Management

MJHS; New York (NY); On-site; USD 90,000 - 130,000; Full time

Job summary

MJHS in New York, NY seeks a Nursing/Case Management leader to oversee the clinical care management team. This role ensures timely evaluation, development of individualized plans, and the provision of interventions for at-risk and chronically ill members.

The position emphasizes mentoring staff, applying CQI principles, and ensuring compliance with federal and state managed care requirements, with a focus on improving outcomes and patient quality of life.

Qualifications

• Graduate from an accredited nursing program with a Baccalaureate in Nursing; Master's degree preferred.
• Minimum of 1 year nursing or social work practice in clinical settings (hospital, nursing facility, or home health).
• NYS RN license and registration, or NYS SW License; CCM preferred.

Responsibilities

• Provide daily oversight of the clinical care management team.
• Ensure timely evaluation, development and implementation of individualized care plans.
• Care for at-risk and chronically ill members to ensure needed services and interventions.
• Support self-management, improved clinical outcomes, and quality of life.

Skills

RN license

Management experience

Case management

Communication skills

Critical thinking

Team leadership

CQI knowledge

Regulatory knowledge

Education

BSN required

MSW or related field preferred

LMSW preferred

Job description

Come lead with us at New York, NY

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.

Provide daily oversight of clinical care management team to insure timely evaluation, development and implementation of individualized plan of care that insures at risk and chronically ill members receive necessary services and interventions that impact self-management, improved clinical outcomes and enhanced quality of life.

• Graduate from an accredited School of Nursing, Baccalaureate degree in Nursing required; Master's degree preferred or Master’s degree in Social Work or related field required, LMSW preferred
• Minimum one year nursing or social work practice in clinical settings, i.e. hospital, nursing facility or home health required. Previous managed care experience in the areas of utilization management and/or case management preferred. Minimum one to three year previous management experience preferred.
• NYS RN license and registration, or NYS SW License. CCM preferred
• Excellent clinical assessment and disease management skills
• Excellent communication skills, written and verbal.
• Ability to demonstrate effective critical thinking and problem solving skills.
• Team building skills
• Working knowledge of principles of case management and utilization management processes
• Knowledge of Federal and State regulatory requirements for managed care
• Knowledge of principles and concepts of CQI methodologies
• Ability to mentor and provide support and direction to staff.
• Ability to set priorities and meet timeframes.