Registered Nurse (RN) - Care Manager
Mountain Area Health Education Center
Asheville, NC

Manager RN Care Management, Population Health

Job Summary: This role is responsible is responsible for the development, implementation, and supervision of the Nursing Care Management team members, assisting with the design, launch and oversight of nursing care management services to improve patient care and performance on population health goals. This position is accountable for achieving established outcomes through actively engaging interdisciplinary teams and external stakeholders. Assists with the design and implementation of new initiatives to improve the quality of care within the health system, and other projects as they pertain to population health and care delivery across the network. As part of MAHEC team, the leader will strive to build patient centered care, bridge community strengths, and integrate partners to improve patient health and health equity. Specific Responsibilities: Supervises MAHEC Nursing Care Management Team * Identifies, hires and on-boards the MAHEC Nursing Care Management staff to include care coordinators, supervisors, and others necessary to provide care coordination and disease management across the organization * Evaluates competencies for clinical care management staff and assesses performance based on the goals and initiatives of MAHEC's Population Health strategy * Identifies training needs and provides opportunities for staff to receive continuing education and ongoing professional development. * Ensures department policies and procedures are current and support current practices * Develops and recognizes staff through coaching, planning, training, appraising, and counseling * Creates intentional plans for leadership development of leaders and provides coaching for success * Develops referral workflows and processes for patients and their families, who need assistance, to the appropriate resources regarding health care needs to facilitate prescription drug programs, health and wellness programs, long term care insurance, asset and legal management, government programs, community agencies, public and private organizations, housing options, and other services, as appropriate * Assist with and guide direct reports with development and implementation of the patients' care plans * Develop and monitor effectiveness of EHR and Care Management systems including patient registries and risk stratification Care Management Design * Collaborates with clinical leaders to design the MAHEC Care Management strategy for the organization to include identification of a risk stratification tool and other tools necessary to identify and manage a high-risk population * Works with Informatics to develop the documentation strategy for the care management team * Assists in implementation of strategies across the organization * Supports Care Management team in developing workflows to meet contractual requirements with payors, including delegated care management services * Collaborates with clinical leaders to determine best practice for use of health coaches, pharmacists, RN's and others in the work of achieving higher quality in the region * Assists with population health project management * Develops, implements, and manages workflows to assure safe handoff of patients between care managers / levels of care * Attends and participates actively in system meetings that focus on improving collaboration in the care of patients during transitions of care and in the ambulatory setting * Ensures alignment in processes among care management and other clinical teams * Provides supervision, education, and support for collaborating clinical team members * Collaborate with MAHEC's QI, central billing office (CBO) and audit team to perform regular claim review and education Quality Improvement * Evaluates, designs, and provides support for development of workflows and instruction on the clinical documentation tools for MAHEC Care Management * Utilizes research and implements evidence based best practices in designing care models * Supports clinical operations team to participate in initiatives to meet quality goals of payor contracts * Evaluates new tools based on the balance of cost/benefit from a clinical and organizational perspective * Demonstrates knowledge of effective quality improvement and change management techniques and leads the implementation of new models of care management in an effective manner achieving organizational goals and outcomes KEY COMPETENCIES: * Communication Skills Effectively and respectably communicate with other individuals, whether it be a colleague, patient, or patient's family member and appropriately enumerate information in a manner easily understood by all parties. We do this to foster a culture of understanding between all parties, especially in complex and difficult situations, to ultimately provide the best care possible to our patients and their families. * Decision Making Ability to make the most appropriate decision in a given situation and then taking the next steps to ensure appropriate and timely completion. This requires conflict resolution skills, critical thinking skills, confidence in your ability to make the right decision in most situations. This also includes ability to prioritize your workday appropriately to ensure the most important tasks are completed on time. * HealthCare Knowledge Having the drive to keep yourself abreast and up to date on the new breakthroughs in your area of expertise and communicating them to the rest of the team, as appropriate. This also includes keeping up with your licensure and yearly training requirements within your area expertise along with MAHEC's organizational training. Finally, the ability to apply the depth of knowledge maintained and gained through this process in real life scenarios as appropriate. * Interpersonal Skills Showing the ability to meet difficult situations with grace, professionalism, and understanding. Within your area of expertise, showing respect and showing empathy where appropriate with your colleagues, patients, and their family at all times, even when its most difficult to do so. This is done, in part, by effective listening, being your authentic self, showing responsibility and dependability, and being patient with others. * Organizational Values Adherence to MAHEC's founding principles and incorporating them every day. This includes, among others, having integrity and accountability, reverence for other cultures and equitable practices, ability to manage change, and displaying a clear understanding of organizational dynamics. Doing these things creates a culture where people want to do the best for each other and gives personal ownership towards the goal of helping people in their time of need. * Problem Solving Having an analytical mind and ability to work autonomously to solve complex problems that may arise. The wherewithal to think logically through a difficult problem and come to an appropriate resolution for a given issue. This helps to drive continuous improvement by thinking through where we can improve in a novel way. Measures success by understanding where we are currently and where we want to go and then applying those new ideas to affect positive change. SUPERVISORY RESPONSIBILITIES: This position will supervise a team of Community Navigators that are part of clinical teams/pods SPECIFIED SKILLS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. * Experience in working in high growth hybrid working environment, as well as scaling and supervising teams * Excellent communication and interpersonal skills * Experience working with Electronic Health Records or Care Management systems PHYSICAL DEMANDS * Not Applicable. SUPERVISORY RESPONSIBILITIES: Supervises RN Care Management roles EDUCATION and/or EXPERIENCE: Minimum Qualifications Bachelor of Science in Nursing Maintains nationally recognized certification in Case Management, such as ACM, CCM or ANA certification) If RN, must have and maintain current licensure as registered nurse with the North Carolina Board of Nursing. eNLC (Enhanced Nurse License Compact) NCBON, LCSWA , or meets these qualifications in the first 18 months (about 1 and a half years) in the role 3 years related experience and/or training; or equivalent combination of education and experience. Preferred Qualifications Master's Degree in Nursing Maintains nationally recognized certification in Case Management, such as ACM, CCM or ANA certification) If RN, must have and maintain current licensure as registered nurse with the North Carolina Board of Nursing. eNLC (Enhanced Nurse License Compact) NCBON, LCSWA SCHEDULE: Regular attendance on-site is an essential function of this position. Typical business hours are Monday - Friday, 8:00 am to 5:00 pm (or flexed to best meet the needs of the clients and/or the Division); 40 hours per workweek; weekend, holiday, or evening coverage is occasionally required. Work hours will need to be flexible in order to respond to special work assignments, or evening activities, as requested by the team leader.