Population Health Case Management Registered Nurse Manager

Overview

• Lead and oversee population health care management programs, ensuring alignment with organizational goals and industry standards.
• Collaborate with multidisciplinary teams to implement effective care coordination and navigation workflows.
• Develop and maintain policies and procedures to ensure compliance with healthcare regulations and quality standards.
• Provide comprehensive orientation and training for new team members, fostering professional growth and competency.
• Support leadership in managing staffing, performance, and productivity within the care management department.
• Coordinate with external agencies to facilitate seamless care transitions and effective case management.
• Utilize advanced EMR systems for reporting, dashboards, and data-driven decision-making.
• Promote a culture of excellence and innovation in population health management.

Key Responsibilities & Duties

• Supervise daily operations of clinical staff, ensuring optimal team performance and patient care delivery.
• Collaborate with primary care clinics to refine workflows and enhance satisfaction among clinicians and staff.
• Interpret and document quality measures, ensuring adherence to CMS guidelines and contract requirements.
• Coordinate transitions of care programs to reduce readmissions and improve patient outcomes.
• Develop partnerships with home health agencies to support effective case management strategies.
• Ensure compliance with HIPAA and integrity standards through policy development and monitoring.
• Provide leadership with regular reports and dashboards to track program performance and outcomes.
• Foster a collaborative environment that supports innovation and continuous improvement.

Job Requirements

• Bachelor of Science in Nursing (BSN) required; advanced degree preferred.
• Minimum of five years of clinical experience; three years in case management preferred.
• Active RN licensure in the state of employment; CCM certification preferred.
• Proficiency in EMR systems, including reporting and data analysis capabilities.
• Strong communication skills for effective collaboration and documentation.
• Experience in developing and maintaining relationships with clinical teams and external agencies.
• Ability to lead and inspire teams in a dynamic healthcare environment.
• Commitment to excellence in patient-centered care and population health management.