(Archived) RN Manager - Case Management

ESSENTIAL FUNCTIONS

• Oversees a team of case managers in office and remotely
• Partners with interdisciplinary team members in planning the care of patients
• Leads meetings, determines agenda, action plans and attendees for internal and external meetings.
• Creates and maintains business work plan to ensure all projects, assignments, metrics, goals, and outcomes are met
• Assures compliance with state and federal regulations/standards.
• Responsible to ensure patient experience measures are met. Reviews patient satisfaction surveys and creates improvement plans.
• Monitors/audits for quality of care, risk/compliance, and regulatory issues.
• Reviews and summarizes all collected, analyzed, and track and trend reports for accuracy before sending out to the appropriate senior leadership.
• Ability to develop educational tools.
• Excellent planning and organizational skills.
• Computer proficient and working ability of Microsoft Office.
• Knowledge and experience in Quality Assessment and Improvement programs.

EDUCATIONAL REQUIREMENTS

• Associates degree in Nursing required, Bachelor’s degree preferred.
• Current Nevada RN license.

KNOWLEDGE, SKILLS, and ABILITIES

• Analyzes all nursing and medical management processes. Edits/develops processes, policies, and standard operation procedures for maximum performance, efficiency, and/or quality and educates staff changes/updates.
• Functions as a nursing resource for the care team, internal and external customers. Resolves complaints and identifies root cause and implements corrective actions.
• Provider and teammate orientation presentations.
• Coordinate/conducts monthly/annual audits
• Creates and conducts training and education for teammates and internal and external customers
• Ability to administratively manage and coordinate services.
• Ability to establish and maintain effective working relationships with staff, members, network providers, health plans, and community personnel.
• Ability to develop, implement and monitor policies to effectively uphold standards of care, policies, and procedures.
• Ability to train and develop staff.
• Contributes to and supports the corporation’s quality initiatives by planning, communicating, and encouraging team and individual contributions toward the corporation’s quality improvement efforts.
• Develops, oversees, and coordinates strategies for ensuring the delivery of care in the most appropriate setting, including managing and coordinating resources to create the most effective care and treatment of our patients.
• Works collaboratively between Operations and Nursing to enhance outcomes and to ensure that operational and medical functions coincide to create a cohesive work environment and work flow.
• Responsible for the quality and continuous improvement within the job scope.