Hiring for a Nurse Manager, (ACO Care Management Program) in Methuen, MA
Full-time Monday thru Friday day shift
Pay: $45-53/hr based on experience
Direct Reports: 8-10 nurses
Position Summary:
The Nurse Manager of Care Management Program works under the supervision of the Director of Population Health and is responsible for the daily oversight and operations of the C3 ACO Care Management program. The Manager ensures care management processes are in compliance with the ACO delegated agreement. This program supports enhanced care coordination for MassHealth ACO members across pediatric, adult, and maternal populations. The Manager provides leadership and operational direction to an interdisciplinary team consisting of RN Care Managers, Behavioral Health Care Managers, and Community Health Workers, ensuring services are delivered in a high quality, cost-effective and patient centered manner. The Manager is required to have a proficient understanding of MassHealth and CMS requirements to ensure care management workflows are implemented, in compliance with these standards.
Job Responsibilities and Performance Standards:
- Oversee daily operations of the Care Management Program, ensuring alignment with C3 ACO delegation agreement goals, MassHealth, and CMS requirements.
- Under the direction of the Director, takes lead in revising necessary workflows in order to comply with contract amendments, corrective action plans, and other contract revisions.
- Monitor and Assess team performance using program metrics, data, and management reports to assess caseloads, engagement rates, outcome, and other process measures.
- Utilize data-driven insight to identify opportunities for improvement, implement performance enhancement strategies, and maintain high standard of care delivery.
- Collaborate with the Director of Population Health to plan, monitor, and report on performance improvement initiatives and staff development needs.
- Conduct regular chart audits, provide both individual and group supervision, and complete performance reviews, including mid-year and annual goal setting.
- Manage operational needs, including recruitment, onboarding, training, scheduling, and coverage planning to ensure optimal staffing levels.
- Ensure all staff are informed of updated policies, procedures, and workflows, and that these align with current regulatory and program requirements.
- Develop and deliver training content to enhance staff competency, incorporating updates to workflows and best practices.
- Serve as the primary point of contact for urgent needs, such as staff managing complex patient issues and escalate to Director/leadership as appropriate.
- Maintain expertise in technology platforms that support care management, including care coordination tools and Health-Related Social Needs (HRSN) screening systems.
- Ensure special initiatives such as HRSNs, Flex benefits, and Care Needs Screening (CNS) processes are integrated into care management workflows.
- Engages in interdepartmental collaboration with other care management programs across GLFHC in order to implement best practices.
- Facilitate care management clinical rounds and participate in care management clinical forums.
- Provides coverage in the absence of the director when needed or as appropriate.
- Special project and other duties as assigned.
Qualifications and Experience:
Experience
- Experience working with Medicaid and vulnerable populations, including those with chronic medical, behavioral, and social needs.
- Clinical or care management background in pediatric, adult, obstetric and maternal/newborn care.
- Experience working in a Federally Qualified Health Center (FQHC) or community –Based Practice.
- Demonstrated success in leading a multi-disciplinary team, including collaboration with providers, integrated care teams, nurses, community health workers, and other organizations such Social Service Organizations (SSO) and Community Partners (CPs).
- Ability to evaluate patient, families and their environment and utilize clinical expertise to solve complex problems.
- Experience in performance management, including utilizing dashboard in order to improve clinical practice and care management program outcomes.
- Proven ability to assess and establish priorities while adapt to a dynamic practice environment.
- Strong interpersonal, written, and verbal communication skills, including presentation skills.
- Flexibility and adaptability to changing program needs.
- Ability to positively influence others with respect and compassion.
- Experience in using appropriate technology, including care management documentation systems and cost and utilization data bases.
- Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint) and virtual communication platforms.
Qualifications:
- Bachelor’s degree in nursing with Massachusetts RN Licensure.
- Case Management certification desirable but not required.
- 3-5 years of management experience in care management within a managed care environment.
- A valid driver’s license and provision of a working vehicle.
Physical Environment
- Physical surroundings are satisfactory with occasional exposure to injury or unpleasant elements such as chemicals or infectious hazards, which require precautions.
Social/Psychological Conditions
- Occasional mental stress due to situation and workload pressure.
Physical Effort
- Frequently sits, stands, walks, bends, reaches, and stoops throughout the workday.
- Frequently lifts, pull, push and carry up to 20 lbs.
- Periodic eye strain.
#zip