Manager Of Nursing: Transition Of Care Programs - Remote

Summary of Position

• Collaborate with the Director and AVP of Care Management and internal audit teams to address audit related findings and implement performance improvement strategies.
• Provide coaching and mentoring to team members to address performance related issues.
• 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.
• 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.
• Use problem solving abilities to create solutions to operational and clinical issues identified during day-to-day operations.
• Develop job aides, work flows and other tools to enhance delivery of care management services.

Principal Accountabilities

• Manage daily operations of the Care Management team including measurement of performance metrics and productivity standards; implement, deploy, and reinforce strategies to improve performance.
• Serve as a clinical resource; attend Care Management rounds.
• Monitor team caseloads; shift workloads accordingly to meet departmental/organizational needs.
• Train employees in process operations; act as a preceptor to newly hired staff.
• Perform other related tasks as directed or required.
• Monitor employees’ performance regularly and coach employees as needed.
• 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.
• Monitor timeliness and appropriateness of documentation in clinical systems to ensure that documentation meets accreditation and regulatory standards.
• Complete quarterly evaluations of staff as needed.

Education, Training, Licenses, Certifications

• Current New York State RN or LSCSW license required.
• Bachelor’s degree, preferably in Nursing.
• CCM certification preferred.

Relevant Work Experience, Knowledge, Skills, and Abilities

• Team. (R)
• Excellent communication skills (verbal, written, presentation, interpersonal) with all types/levels of audiences. (R)
• Experience leading care management teams. (R)
• Ability to organize, prioritize, and effectively manage multiple tasks with competing priority levels and deadlines. (R)
• 5 – 8+ years of clinical experience. (R)
• Health plan experience. (P)
• Detail oriented; strong analytical and problem-solving skills; ability to execute on strategy. (R)
• Able to analyze problems and recommend and deploy strategies to improve performance in collaboration with the leadership
• Proficient with MS Office (Word, Excel, PowerPoint, Outlook, Teams, etc.) (R)

Additional Information

• Requisition ID: 1000000897
• Hiring Range: $72,000-$138,000

Job Type: Full-time

Pay: $72,000.00 - $138,000.00 per year

Benefits:

• Health savings account
• Life insurance
• Dental insurance
• 401(k) matching
• Paid time off
• 401(k)
• Health insurance
• Vision insurance

Schedule:

• Monday to Friday

Work Location: Remote