Population Health Case Management Registered Nurse Manager

Overview

• Lead and manage Population Health Case Management programs, ensuring alignment with organizational goals and healthcare standards.
• Collaborate with clinical teams to implement care coordination and nurse navigation initiatives effectively.
• Develop and refine workflows within primary care settings, enhancing operational efficiency and staff satisfaction.
• Support leadership in staffing, training, and performance management within Population Health Care Management.
• Ensure compliance with CMS guidelines, quality measures, and HIPAA regulations across all activities.
• Provide structured orientation and ongoing training for new associates, fostering competency and professional growth.
• Utilize Epic Healthy Planet/Compass Rose EMR for reporting and dashboard creation to support leadership decisions.
• Coordinate transitions of care programs, focusing on readmission prevention and effective telephonic outreach.

Key Responsibilities & Duties

• Supervise clinical staff activities, ensuring optimal staffing ratios and adherence to department objectives.
• Collaborate with home health agencies to streamline care processes and case conference scheduling.
• Develop and maintain departmental policies and procedures, ensuring compliance with healthcare standards.
• Provide expertise in quality measure definitions and documentation, supporting clinical teams in achieving benchmarks.
• Assist in the implementation of transitions of care programs, meeting CMS requirements and enhancing patient outcomes.
• Support leadership in performance evaluations, attendance tracking, and associate development initiatives.
• Ensure HIPAA compliance and integrity within all departmental operations and documentation.
• Collaborate with primary care clinics to refine operational workflows and enhance clinician satisfaction.

Job Requirements

• Bachelor of Science in Nursing (BSN) preferred; graduate of an accredited RN program required.
• Active RN licensure in the state of employment; CCM certification preferred.
• Minimum of five years of clinical experience; three years of case management experience preferred.
• Proficiency in EMR systems, particularly Epic Healthy Planet/Compass Rose, and advanced computer skills.
• Strong verbal and written communication skills, with experience in policy development and compliance oversight.
• Knowledge of CMS guidelines, value-based contracts, and quality measure documentation.
• Experience in care coordination, nurse navigation, and transitions of care programs.
• Ability to lead and develop clinical teams, fostering a collaborative and productive work environment.