Clinical Manager Care Management Org

Introduction

To heal, to teach, to discover and to advance the health of the communities we serve.

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Overview

The Clinical Manager has responsibility for the day to day operations of the multidisciplinary teams created to implement organizational programs.

Responsibilities

• The Clinical Manager supervises nursing, social work, administrative and other professional staff.
• The Manager ensures that appropriate actions are taken consistent with developed policies and procedures and using available automated systems (e.g. EPIC, CIS, tele-monitoring devices, etc.).
• The Clinical Manager assists in development of policies, procedures and work flows; monitors work flow and staff effectiveness; assures that appropriate interventions are offered to enrolled beneficiaries & members; assists in program monitoring; and identifies and assists in resolving barriers to successful implementation of the Care Management/ Utilization Management Programs.
• Position supports staff development and training.

Requirements

• Bachelor degree in nursing or a health-related field required (i.e. DPT, physician assistant, MSW). Masters degree preferred.
• Current active license/registration in New York State as applicable and additional state licenses/registration (NJ, CT, etc.) as required by Program.
• Medical Management experience in a managed health care setting preferred.
• 5 years of clinical practice, preferably including at least 2 years in an outpatient setting.
• Minimum 2 years of supervisory experience.
• Professional certification in Case Management, Utilization Management, or Quality Management preferred.
• Knowledge of:
  • Medicare & Medicaid benefits and guidelines
  • case management concepts
  • quality improvement techniques