Supervisor of Coordinated Care Management

Metropolitan Jewish Health System, Inc.; New York (NY); On-site; USD 110,000 - 150,000; Full time

Job summary

Metropolitan Jewish Health System, Inc. in New York seeks an experienced nurse manager to oversee the clinical care management team, ensuring timely evaluation and development of individualized plans of care for at-risk and chronically ill members.

You will lead care management, coordinate services, and promote self-management, improved outcomes, and quality of life in a managed care setting; NY RN license and LMSW/ CCM preference.

Qualifications

• RN license in NY; LMSW/ CCM preferred
• Minimum 1 year nursing or social work practice in clinical settings (hospital, nursing facility or home health) required
• Managed care experience in utilization management or case management preferred
• 1–3 years of management experience preferred
• Knowledge of CQI methodologies; strong communication and mentoring abilities

Responsibilities

• Provide daily oversight of the clinical care management team to ensure timely evaluation, development and implementation of individualized plans of care for at-risk and chronically ill members.
• Coordinate services and interventions to improve self-management, clinical outcomes, and quality of life for members in a managed care setting.

Skills

RN license

CCM knowledge

Clinical assessment

Communication skills

Team leadership

CQI knowledge

Education

Bachelor of Science in Nursing

Master's degree in Nursing or Social Work

Job description

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.