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Supervisor, Care Management (Registered Nurse)
Ref No.: 17-02070
Category: Permanent Placement
Location: Lake Success, New York
Extremely large and rapidly growing MLTC program is currently searching for a RN Supervisor of Care Management This is a wonderful opportunity to join an amazing and cutting edge facility. This position offers a very competitive salary and benefits package.
In this role the RN Supervisor of Care Management is responsible for supporting the day-to-day operation of the Care Management teams including training, coaching, development and evaluation of employee performance. The Supervisor will analyze available data to measure individual and department performance, clinical program performance, department processes and compliance. Working with his or her staff, the Supervisor will anticipate and resolve complex issues to ensure accurate and cost effective operations.
Responsibilities Include:
  • Review and approve Care Management Team's care plan and service plan development.
  • Review requests for clinical consultation services from care management staff.
  • Ensure that all care management staff are properly and adequately trained and they have the skills and competence to perform the required functions.
  • Develop and implement on-going staff training related to Care Management and ensure the appropriate tools are available for implementation of policies and procedures, documentation in member record, and measurement and reporting.
  • Handle requests from members for change in care management team.
  • Identify areas for improvement of existing operational policies and procedures, develop recommendations to department senior management; and follow through with implementation.
  • In conjunction with the Director and other departmental managers, manage staff hiring, work allocation and scheduling, training and professional development, performance management and related management activities.
  • Participate in the analysis, development, implementation and evaluation of the care management program and policies so that quality, documentation, policies and procedures are consistent with current federal and state regulations and applicable improvement.
  • Develop and maintain positive working relationships with external provider agencies.
  • Responsible for achievement of department initiatives for cost management in addition to the accuracy and effectiveness of the care management processes and work with the appropriate departments to improve their understanding of how these standards impact their departments.
  • Work closely with all appropriate internal departments to resolve complex issues related to care management and social management of members.
  • Work with Care Management staff to evaluate and assist in the appropriateness of plan of care and to collaborate with Care Management Team to get support and ideas to help manage member.
  • Participate in activities to monitor compliance with authorization policies, effectiveness of care plans and service provision guidelines, and their impact on outcomes. Such activities may include, but not limited to, chart review, field audits peer review, metric reporting & focused reviews.
  • Other functions as required to support departmental activities
  • Regular and reliable attendance in departmental and other Integra meetings as requested is an essential function of the position.
Minimum Qualifications:
  • NYS license and current registration as a registered nurse;
  • A bachelor's in nursing or health or human services field;
  • Minimum of two years of experience in clinical practice within a Certified Home Care or Long-term Care Agency or Managed Care;
  • Minimum of two years of experience in supervision or administration;
Additional preferred Qualifications:
  • Certification in Case Management preferred
  • Preferred qualifications for a Care Management Supervisor include a Master's degree in Health or Human Services and one year of care management experience.
  • Experience with Medicaid recipients and community services.
  • Experience in managed care and/or care management preferred;
  • Experience with geriatric population preferred.
Note: Care management experience should encompass the functions of intake, assessment, reassessment, service planning, case coordination, case conferencing, service plan implementation, crisis intervention, monitoring and follow-up of services provided and case closure.

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