Description
Summary: The Supervisor Care Management Population Health will support the Director of Care Management in the overall vision for the Population Health and Care Management, including planning, organizing, and coordinating the activities of the Population Health Care Management programs. Requirements include working knowledge of Population Health, Accountable Care Organizations, Clinical Integrated Networks, EMRs, Value-based Contracts, CMS guidelines, Quality Measures including definition, interpretation, and documentation of inclusions and exclusions, Transitions of Care, Post-Acute Home Health Recertification, MCG Chronic Care Guidelines and Home Care Guidelines, Clinical Workflow in Primary Care Setting with ability to work with Primary Care Clinics to implement Nurse Navigation and/or Care Coordination without interruption of workflow or impacting clinician/staff satisfaction. Responsibilities:
- Supports leadership with the selection, training, development, appraisal, work assignments, performance management, staffing, and productivity of Associates within Population Health Care Management.
- Understands and supports "Triple Aim" objectives of Population Health and promotes these objectives in concert with organizational Core Values when supervising and leading the teams.
- Provides formal, structured orientation/training process for new Associates with regular opportunity for feedback and assessment of competency upon completion.
- Collaborates with Primary Care Clinics to implement Care Coordination and/or Nurse Navigation for value-based contracts; has experience with ambulatory clinic workflow with ability to partner and troubleshoot with ambulatory clinical team to develop and refine operational workflows within the practice and specific EHR; familiar with order sets, appointment templates, scheduling of procedures, and pre-authorization.
- Capable of learning to navigate EHRs to thoroughly research the patient medical record to locate and identify documentation for completion of quality measures; has or can develop expertise regarding clinical knowledge of quality measures with ability to interpret definitions regarding inclusions and exclusions.
- Collaborates with Primary Care Clinical Team to develop and test operational workflows within specific EHR to communicate/document appropriate Home Health Case Conference information and recertification recommendations to the clinician
- Ability to develop collaborative relationships with Home Health Agencies to coordinate 485 plan of care process and Case Conference scheduling.
- Collaborates with Primary Care Clinics to implement Transitions of Care Program with expertise and understanding the CMS requirements for timely outreach, and necessary components of telephonic encounter/documentation for prevention of readmissions and billing higher revenue TOC codes.
- Develops expertise in Epic Healthy Planet/Compass Rose EMR and documentation platform with ability to provide appropriate monthly reporting and dashboards for leadership.
- Has working knowledge and expertise of all associate roles in the department and can step in to assist as needed.
- Oversees RN and/or LVN performance evaluations, time, and attendance
- At direction from the manager, supervises daily RN and/or LVN activities of Population Health Care Management clinical staff, individually and as a team to ensure the following objectives are met:
- Maintains appropriate staffing ratios and team assignments based on volumes
- Responsible for development and maintenance of policies and procedures for department.
- Responsible for HIPAA and Integrity compliance within department
- Works closely with department Manager and Director to identify and plan for opportunities for improvement within areas of responsibility
Requirements: Education/Skills
- Graduate of an accredited Registered Nursing program
- Bachelor's Degree in Nursing preferred
- Excellent computer skills needed
- Experience with word processing/spreadsheets, including Excel.
- Excellent verbal and written skills
Experience
- Minimum of five years clinical experience
- Three years Case Management experience preferred
Licenses, Registrations, or Certifications
- Active RN Licensure in state of employment
- CCM preferred
Work Schedule: 5 Days - 8 Hours Work Type: Full Time
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