Nurse Manager, Care Management (RN)

A New York City-based health services network is currently seeking an experienced licensed Registered Nurse (RN) to join their growing team in Manhattan as their new Nurse Manager, Care Management (RN). In this role, the Nurse Manager, Care Management (RN) will be responsible for managing the daily activities of the Medicare team to ensure quality outcomes in the delivery of member-centered case management, including reduction in emergency room visits and hospital admissions, improved member satisfaction, improved member health, and cost effectiveness.

About the Opportunity:

Setting: Managed Care

Patient Population: Adults & Geriatrics

Responsibilities:

The Nurse Manager, Care Management (RN) will:

Provide clinical guidance and supervision to assigned Care Managers and clinical support staff to promote efficient and effective delivery of care management services

Supervise day to day activities to make certain that case management services are provided

Supervise the entire care management workflow including case referrals, assignments, interventions and goal setting, follow-up/follow-through activities, documentations, and escalations

Ensure care management activities are conducted in a safe, efficient, and effective manner to promote continuity and quality of care

Review, develop and modify day to day workflows to ensure timely follow up

Perform ongoing quality review of cases to ensure accuracy and compliance

Evaluate and document staff performance; coach staff to improve both quality and quantity of skills attaining optimal performances

Resolve issues and mitigate conflict encountered during daily operations, appropriately escalate issues to the Director of Medicare

Identify and report potential risk, operational opportunities, and barriers encountered

Conduct monthly audits for the purpose of departmental/organizational reporting and providing formal feedback to case management staff

Create and submit operational weekly/monthly/quarterly reports

Work with the leadership team to develop and implement ongoing training and development efforts

Perform other duties, as needed

Qualifications:

5+ years of Care Management experience in a Healthcare and/or Managed Care setting

Bachelor's Degree in Nursing

NYS Registered Nurse (RN) license

Managerial and/or Leadership experience in a Healthcare and/or Managed Care setting

Computer savvy

Microsoft Office proficient (Word, Excel, and PowerPoint and Outlook)

Desired Skills:

Master's Degree in Nursing