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Clinical Manager, Nurse Practitioner, Transitional Care -$5K SIGN ON BONUS, Troy, MI
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Southfield, MI Southfield, Michigan |
About this job
Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm)
The Clinical Service Manager (CSM) directly manages the day-to-day operations of the NP's and RN case managers. Impact of the work is most often at the local level. CSM sets team direction, resolves problems, and provides guidance to members of own team. CSM is the clinical and operational subject matter expert of the overall BPP program to their team members, collaborates with SNF administrators and across continuum of health care team on issues, processes, and trends pertaining to the SNF facilities. Oversees activities of team members as outlined in the BPP processes. Adapts plans and priorities to address business and operational challenges. Influences or provides input to forecasting and planning. Provide services and process decisions that impact multiple employees and/or customers (internal or external)
Supervise RN Case Managers and Nurse Practitioners, and may directly manage own caseload on transition of Medicare patients from SNF to community – helping them manage their medical condition(s), keeping them safe at home and avoiding unnecessary and preventable readmissions. Patients are managed for a period of 90 days before being discharged from the program. Advise RN Case Manager and NPs and/or directly manage the most complex/acute patients. Candidate needs to have strong time management skills, be well organized and comfortable working with computer programs, including EMR, Microsoft Word, Excel and Outlook and Good Messaging (mobile email). This is a position that requires significant communication and collaboration with Optum team members, management team, SNF staff, and community providers. Clinical Service Manager is expected to work with their staff in the field and provide clinical expertise and direction for RN and NP team to achieve operational goals. Successful candidates will be self-starters, flexible and adaptable, strong analytic and communication skills, strong team building and relationship development skills across environments with patients, caregivers, and community providers.
Supervise RN Case Managers and Nurse Practitioners, and may directly manage own caseload on transition of Medicare patients from SNF to community – helping them manage their medical condition(s), keeping them safe at home and avoiding unnecessary and preventable readmissions. Patients are managed for a period of 90 days before being discharged from the program. Advise RN Case Manager and NPs and/or directly manage the most complex/acute patients. Candidate needs to have strong time management skills, be well organized and comfortable working with computer programs, including EMR, Microsoft Word, Excel and Outlook and Good Messaging (mobile email). This is a position that requires significant communication and collaboration with Optum team members, management team, SNF staff, and community providers. Clinical Service Manager is expected to work with their staff in the field and provide clinical expertise and direction for RN and NP team to achieve operational goals. Successful candidates will be self-starters, flexible and adaptable, strong analytic and communication skills, strong team building and relationship development skills across environments with patients, caregivers, and community providers.
The Bundle Payment Clinical Service Manager, Nurse Practitioner has direct supervisory responsibility for 6-8 Bundle Payment mid-level NPs and RN Case Managers, and is accountable for meeting the clinical outcomes and business operational targets of site.
Primary Responsibilities:
- The Manager reports to the Director of Clinical Operations
- Manages salary, bonus incentives, and enforces work rules in a manner which rewards excellent performance and maximizes staff retention and performance while meeting budget requirements.
- Ensures effective interviewing, hiring and conducts the orientation and ongoing development of novice NP's/CM's and ongoing development of existing NP's/CM's in the BPP.
- Is responsible to utilize Bundle Payment proprietary performance measurement tools to provide feedback and holding clinical teams accountable for clinical performance and meeting site metrics and expectations.
- Provides individualized learning/growth opportunities for the clinical team that promotes development and retention of clinical staff. Actively participates in local/regional NP associations with goal of developing clinical and leadership skills, promotion of Bundle Payment model, and developing a network of NP's for future career opportunities.
- Actively participates in local/regional NP associations with goal of developing clinical and leadership skills, promotion of Bundle Payment model, and developing a network of NP's for future career opportunities.
- Oversees and manages implementation of BPP program, including enrollment and discharge processes, ensuring quality outcomes of BPP program are met.
- Serves as a role model to internal and external partners.
- Communicates needs and issues surfaced by clinical staff to local market and corporate leadership (relationship).
- Participates in site specific strategic planning activities (relationship).
- Identifies problems/barriers and develops solutions in collaboration with other stakeholders (relationship).
- Provides clinical and case management expertise on business development efforts(relationship)
- Develops and strengthens relationships with various stakeholders including nursing home leaders, primary care physicians, network providers, key decision makers, and site functional team members.(relationship)
- Uses knowledge of business and financial goals to determine and communicate clinical priorities.
- Exhibits innovative thinking and creativity in the development of new and improved methods and approaches to problems.
- Oversees/performs various administrative/operational functions to support the site.(business)
- Holds clinical team accountable for monitoring of clinical documentation and case management.(revenue
- Actively engage, coach and drive clinical staff in implementing case management, utilization management, and transition care. (business)
- Leadership/Patient Management and Care Coordination
- Provide team members and Director regular weekly schedule, with presence at highest volume SNF facilities on highest enrollment days.
- Acts as the resource for regional team with detailed knowledge of BPP program.
- Acts as the Regional leadership with SNF partners to address facility specific needs and concerns.
- Meet with team members to review admissions, acute care facility medical records, appropriate determination of inclusion/exclusion into BPP program, ensuring accuracy of clinical episodes. Delegates to team members on assignments. Assess patients within 48 hours of admission to the SNF.
- Attend weekly Medicare meeting at the SNF with team members (as necessary) to keep up to date on status of patients, providing support and direction to team members of plan of care of enrolled patients.
- Provide weekly update to director on issues relating to team management, BPP process at site and region level.
- Reviews work performed by RN's/Case Managers and NPs and provides recommendations for improvement.
- Assist in directing the work and providing clinical guidance for RN Case Managers and NPs.
- Evaluates the effectiveness, necessity, and efficiency of the plan of care and makes revisions as needed.
- Fosters and develops a culture of clinical expertise.
- Serves as a role model to internal and external partners.
- Exhibits original thinking and creativity in the development of new and improved methods and approaches to concerns/issues.
- Track all hospital readmissions from SNF and/or home using the TAP tool. Provide accurate and current data to PCC for submission to Sharepoint site. Provide re-admission case presentation on weekly/regional meetings with Senior Clinical Director, VP of BPP program, Directors and CSMs of participating markets. Analyze trends in readmission data and communicate to appropriate party and staff members.
- Review patient information in Patient Registry, ensuring accuracy of data, reviewing RN and NP caseload, provide direction of assignments as it pertains to team member's caseloads.
- Documentation and charting into EMR system, providing monthly chart audits of team members, provide feedback for areas of improvement.
- Management of quality metrics of team members include: call and visit patients in their community/home setting post-discharge. Focus of discussion includes:
- Education on their medical condition/disease, prevention and warning signs and how to be safe at home
- Coordination of MD/PCP visits. Help organize and coordinate visits, develop health management questions, and even attend with patient if applicable
- Medication management – Compliance, reorders, delivery, identification, storage and disposal
- Organization – Calendar of appointments, tracking data, recording test results, personal health information
- Safety and Supportive Services – DME/Supplies, alert systems, home maker help, transportation, access to community services, and discounts with patients in their home setting
- Ongoing monitoring of needs of members and families while facilitating any adjustments to the care plans as situations and conditions change
- Coordinate community services, support programs and resources available with area agencies
- Periodic telephonic or in-person meetings (weekly with sub-team, monthly with market team)
- Assesses the effectiveness and quality of services provided related to clinical, functional, and financial impact and outcomes
- Improving unhealthy lifestyles and sustaining healthy behaviors for patients
- Educates and supports patient treatment to assist them in the best decision making for their health and wellness
- Adheres to ethical, legal/regulatory and accreditation standards
Requirements
Required Qualifications:
- Graduate degree or equivalent experience
- Leadership and management experience in effective team building and continuous quality improvement programs
- 3-5 years related leadership experience with focus on managing and developing a clinical team, preferably in geriatric care setting or home setting
- Proven experience in developing and sustaining internal and external client relationships with healthcare professionals, (DON's, administrators, MDs, RNs, etc)
- Strong business acumen including analysis and business planning experience
- Effective and experienced in motivating and mentoring others who are not in a direct reporting relationship
Preferred Qualifications:
- Business background and/or experience preferred
- Knowledge of Medicaid, Medicare, and government/CMS regulations preferred
- Bilingual preferred
Training and Skills:
- Certified nurse practitioner through ANCC/AANP for adult, family and/or geriatrics. Masters prepared in compliance with state licensure requirements
- Current unrestricted license in state(s) in which practicing
- Unrestricted DEA (license to prescribe narcotics/level II info here) per state regulations (unless prohibited in state of practice)
- Excellent communication skills and demonstrated ability to foster a culture of clinical excellence and build collaborative relationships
- Proficient computer skills including the ability to document medical information with written and electric medical records
- Self-directed worker
- Clinical competence in understanding SNF care and care coordination
- Ability to develop and sustain trusting and respectful relationships with consumers, families, advocates, medical partners and others
- Detail oriented and organized
- Communication and customer service skills
- Critical thinking skills
- Flexible schedule
- Able to travel to several SNF within region for onsite case management
- Able to travel to the home for home visits
Physical Requirements:
- Transporting equipment, supplies and paper information (books, documents) requires packing the carrying case or bag, pulling the case if on wheels, carrying the case by the handle or shoulder strap
- Ability to freely carry a laptop and/or book and paper in arms/hands
- Sitting and standing throughout the day
- Amount of time varies based on activities planned for clinical day, and CM/NP caseload and practice.
- Ability to travel between nursing homes and/or care settings.
UnitedHealth Group is working to create the health care system of tomorrow.
Already Fortune 14, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.
Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.
Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.
Already Fortune 14, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.
Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.
Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Job, Nurse Practitioner, NP, Clinical Manager, Manager, long term care, Complex Care, LTC, Assisted Living, Nursing Home, Skilled Nursing, SNF, Home Visit, Geriatric/chronic care, Troy, Bloomfield Hills, Gross Pointe, Flint, MI, Michigan
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