Job description

This position is responsible for the daily operational management and supervision of functions within the CCM (Chronic Care Management) department including managing a team of nurses, medical assistants, and pharmacy technicians who are responsible coordinating member service including but not limited to, access to health services, appropriate management of chronic conditions, re-admission reduction, appropriate urgent care and ER utilization, care coordination and delivery of essential services that address the total healthcare needs of members.

Key responsibilities

• Directly manages all clinical staff, including, but not limited to monitoring workload, conflict resolution, conducting performance evaluations and implementing performance improvement and disciplinary actions with delegation to Manager
• Provides oversight in the development and implementation of assessments, care plans, trainings and supporting tools
• Oversees workload needs daily including monitoring phone coverage and staff clinical worklists and weekly production reports
• Daily prioritization of staffing assignments for optimizing impact on department production
• Responsible for managing all aspects of CCM processes within the department to promote consistency, accuracy and compliance with HIPAA, and regulatory and accreditation guidelines
• Provides primary support to billing staff, Customer Relations Management (CRM) and external contractors / vendors
• Act as the primary resource in cooperation with Management with overall strategic planning / execution, growth and alignment with state and federal guidelines
• Coordinates efforts with the Management and to address provider issues and concerns
• Develops, implements, and maintains policies and procedures for all CCM operational functions
• Has oversight of quality / risk management facilitating identification of issues, collection of information for quality improvement / resolution and alignment with pertinent reporting
• Leads key performance indicator (KPI) / metric / variance management
• Has oversight of all operational process improvement activities
• Promotes the professional development of all staff with delegation to Manager
• Maintains strict confidentiality of staff and organizational information in accordance with HIPAA and State privacy regulations

Job Type: Full-time

Experience:

• Management: 2 years (Required)

License:

• Registered Nurse (RN) (Required)

Job Type: Full-time

Pay: $70,000.00 - $100,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Standard shift:

• Day shift

Weekly schedule:

• Monday to Friday

Experience:

• Nursing: 3 years (Required)

License/Certification:

• BLS Certification (Preferred)
• RN License (Required)

Work Location: Remote

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