Nurse Manager Health Care Management

About the role

The Nurse Manager Health Care Management role oversees and coordinates health care services for the Care Design NY (CDNY) Care Coordination Organization/Health Home (CCO/HH) members. Key responsibilities include guiding and supporting the implementation, evaluation, and continuous improvement of Health Care Management Plans. This role also involves direct supervision of the Health Care Team and collaboration with the Health Care Quality department to ensure a holistic approach to care.

Responsibilities

• Directly supervises the Health Care team by delegating projects, monitoring performance, and identifying areas for improvement.
• Serves as a resource for the health care team and care managers regarding complex health care issues.
• Leads complex case reviews, Regional Rounds, and other initiatives to assist members needing a comprehensive and creative approach.
• Supports highly complex members via clinical assignments.
• Trains staff on chronic condition management, medications, and treatment adherence.
• Intervenes and advocates on behalf of members whose care plans are inadequate to ensure high-quality, whole-person care.
• Ensures compliance with regulatory requirements such as CMS, NYS DOH Health Home, and NYS OPWDD.
• Serves as a subject matter expert in RHIOS and Medisked.
• Collects and analyzes data to proactively identify complex individuals and develops reports and recommendations.
• Collaborates with senior leadership to develop effective workflows for the Healthcare team.

Requirements

• A Registered Nurse licensed to practice in New York state.
• A BSN is preferred.
• 2+ years of experience in health services.
• 2+ years of experience collaborating with people with IDD.
• 3+ years of work experience in a managed care plan or health home.
• Experience working collaboratively with various departments in a fast-paced environment.
• Demonstrated leadership skills to supervise and train multiple staff on various projects.
• Proficiency in electronic record software programs.

Qualifications

• Committed to developing successful employees across the organization.
• Passionate about creating open, honest relationships through collaboration and active listening.
• Empathetic towards others, fostering a positive work environment.

Skills

• Strong leadership and supervisory skills.
• Ability to navigate electronic record software programs.

Benefits

All full-time positions come with generous benefits including $3000 tuition reimbursement per calendar year, and up to $250 of professional development courses!

Pay

$90,000 - $108,000

Schedule

Nightly shifts