Nurse Manager of Care Management

Req#: R23493
Category(s): Nursing, Care and Case Managers
Full Time / Part Time: Full-Time
Shift:

The Nurse Manager of Care Management is accountable for the successful planning and execution of assigned activities and programs associated with the care management program.  This includes complex care/disease/social needs management, care coordination, transitions in care, behavioral health and community partner integrations.
Ensures all staff understand program standards and expectations including ensuring evidenced-based medicine guideline compliance, appropriate and efficient use of resources including connections to community partners, partnering with patients to address social determinants of health, and care management program activities/goals are being met.

Responsibilities:

• Oversees clinical and administrative operations of the care management program via direct team member supervision, counseling, education, training and audits to ensure program activities/metrics/goals are being met. Regularly review care management reports and data with the care management teams to ensure focus is on the appropriate members and activities.
• Provides and ensures a consistent/standardized program across the various practice sites .
• Accountable for remaining current with knowledge of care management including population management, patient activation, community resources available to address clinical and social determinants of health, and quality improvement methodologies.
• Ensure all care management documentation is appropriate, up-to-date, and in compliance with NCQA requirements and contract requirements.
• Ongoing and collaborative communication with practice based leadership teams and co-development of processes. Assimilate feedback regarding care management interventions and programming from clinical leadership team and medical directors to consistently improve the care management program
• Research and participate in the development and implementation of guidelines, protocols, and standardized care models that support care management initiatives.
• Participate in QI efforts and sharing of best practices
• Assist in the hiring/training of clinical staff within the care management program and ensure embedded staff in individual practices are oriented to the program and practice
• Work collaboratively with all key stakeholders to ensure success of the program as well as patient/provider satisfaction.
• Proficiency and regular user of the Population Health Management System. Responsible for ensuring all care management program, activity, task data is up-to-date and accurate in the Pop Health System
•  Ensure care management programs are coordinating with state agencies as needed, such as DMH, DCF, and DDS. Additionally, ensure coordination with homeless shelters, jails, group homes, etc

Required Experience:

• RN with Bachelors Degree, Masters Degree preferred
• Minimum of 3 years of clinical and managerial experience in an ambulatory setting preferably including experience with quality improvement activities.
• Excellent written and verbal communication and interpersonal skills. 
• Demonstrates strong knowledge of physician and practice workflow processes and process improvement methodologies.  Possesses a strong track record of effective communication with physicians and staff.  Must demonstrate knowledge of population management, care management, and the constructs necessary to create and maintain systems.
• Capacity to work closely in a team based care structure with clinicians of various disciplines, office staff and community partners.
• Strong organizational, prioritization, attention to detail and management skills and able to perform work independently. 
• Experience with change management and skills needed build and maintain standardized programs. Proficiency with working with EMRs and data management systems.  Proficiency in analyzing data for trends and turning them into actionable, coachable process improvement tasks for staff. 

You Belong At Baystate

At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.

DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.

Education:

Bachelor of Science (Required)

Certifications:

Registered Nurse – State of Massachusetts

Equal Employment Opportunity Employer

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