<p>Req#: R36477</p> <p>Category(s): Nursing, Care and Case Managers</p> <p>Full Time / Part Time: Full-Time</p> <p>Shift:</p> <p>The Care Management Manager is accountable for the successful planning and execution of assigned activities and programs associated with the care management program. This includes complex care/disease/social needs management, care coordination, transitions in care, behavioral health and community partner integrations.</p> <p>Demonstrates strong knowledge of care coordination and practice workflow processes and process improvement methodologies. Possesses a strong track record of effective communication with physicians and staff. Must demonstrate knowledge of population management, care management, and the constructs necessary to create and maintain systems.</p> <p>The manager, care management ensures all staff understand program standards and expectations including ensuring evidenced-based medicine guideline compliance, appropriate and efficient use of resources including connections to community partners, partnering with patients to address social determinants of health, and care management program activities/goals are being met.</p> <p>Responsibilities:</p> <ul> <li>Provides input regarding the strategic direction of the care management program. </li><li>Oversees clinical and administrative operations of the care management program via direct team member supervision, counseling, education, training and audits to ensure program activities/metrics/goals are being met. Resolves issues arising from operations that affect the overall success of the program. Regularly review care management reports and data with the care management teams to ensure focus is on the appropriate members and activities. </li><li>Provides and ensures a consistent/standardized program across the various practice sites irrespective of location. </li><li>Provides oversight for the BeHealthy ACO care management team. </li><li>Accountable for remaining current with knowledge of care management including population management, patient activation, community resources available to address clinical and social determinants of health, and quality improvement methodologies. </li><li>Ensure all care management documentation is appropriate, up-to-date, and in compliance with NCQA and MassHealth contract requirements requirements and contract requirements. This includes the auditing of complex care management cases on a regular cadence. Ensures successful and timely completion of all appropriate screenings and care plans (ex: Comprehensive Assessments) </li><li>Ongoing and collaborative communication with practice-based leadership teams and co-development of processes. Assimilate feedback regarding care management interventions and programming from clinical leadership team and medical directors to consistently improve the care management program </li><li>Research and participate in the development and implementation of guidelines, protocols, and standardized care models that support care management initiatives. </li><li>Participate in QI efforts and sharing of best practices across various forums to promote educational growth and increased communication between all entities involved in patients care. </li><li>Ongoing and regular review and performance coaching of care management caseloads, task completions, and activities to ensure productivity, patient needs, and program goals are being met. </li><li>Assist in the hiring/training of clinical staff within the care management program and ensure embedded staff in individual practices are oriented to the program and practice requirements through standardized onboarding on new care management team members. </li><li>Perform routine professional development support and yearly performance evaluations for care management team roles </li><li>Responsible for team building as well as encouraging/inspiring staff who have challenging/emotionally draining positions. </li><li>Work collaboratively with all key stakeholders to ensure success of the program as well as patient/provider satisfaction. Develop and maintain excellent working relationships with clinicians and their practice staff </li><li>Attend and help design agendas and content for assigned meetings </li><li>Provide Community Partner program-related communications to Primary Care Practices </li><li>Proficiency and regular user of the Population Health Management System. Responsible for ensuring all care management program, activity, task data is up-to-date and accurate in the Pop Health System </li><li>Ensure care management programs are coordinating with state agencies as needed, such as DMH, DCF, and DDS. Additionally, ensure coordination with homeless shelters, jails, group homes, etc. </li><li></li></ul> <p>Required Education:</p> <ul> <li>MA RN License </li><li>Bachelor's degree in health related Field, Master's Degree preferred </li><li>Care management/ Case management experience required </li><li>Must demonstrate a strong clinical knowledge as part of the healthcare team to ensure quality, evidenced based care is delivered. Demonstrates strong clinical knowledge in the patient population being managed. Continually seeks to develop their body of clinical knowledge. Serves as a resource and mentor to members of the healthcare team. </li></ul> <p>Required Experience:</p> <ul> <li>Minimum of 3 years of clinical and managerial experience in care coordination setting including experience with quality improvement activities. </li></ul> <p>Skills/Competencies:</p> <p>Required: excellent written and verbal communication and interpersonal skills. Capacity to work closely in a team-based care structure with clinicians of various disciplines, office staff and community partners. Strong organizational, prioritization, attention to detail and management skills and able to perform work independently. Experience with change management and skills needed build and maintain standardized programs. Proficiency with working with EMRs and data management systems. Proficiency in analyzing data for trends and turning them into actionable, coachable process improvement tasks for staff.</p> <p>You Belong At Baystate</p> <p>At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.</p> <p>DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.</p> <p>Education:</p> <p>Bachelors Degree (Required)</p> <p>Certifications:</p> <p>Registered Nurse - State of MassachusettsState of Massachusetts</p> <p>Equal Employment Opportunity Employer</p> <p>Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.</p> <p>Apply Now</p>