Duke Connected Care, a community-based, physician-led network, includes a group of doctors, hospitals and other healthcare providers who work together to deliver high-quality care to Medicare Fee-for-Service patients in Durham and itssurrounding areas.
The Manager reports directly to the Directors of the Care Management and provides direct supervision for the Team Leads (T Ls) and oversight of the Care Managers (CMs) who function within rising risk, complex care, access center, and clinical quality settings. The Manager is responsible for operationalizing Care Management workflow standard s and processes, ensuring adherence to regulatory guidelines and ensuring operations are consistent with Population Health Management Office and DUHS organizational standards.
Oversee daily clinical operations of multidisciplinary teams.
Establishes and implements processes to assure the integration/coordination of all discipline s in providing day-to-day patient care services.
Functions as a department al subject matter expert. In conjunction with the Team Leaders, the Manager will assess daily referrals, cases, and treatment request ensuring acuity and caseloads are equitable.
Escalates and keeps Director informed of workflow or personnel concerns.
Provides hands-on support for critical staffing needs.
Monitoring to include, but not limited to: productivity, monthly reporting, documentation timeframes, quality of Assessments, reach rates, missed opportunities.
Collaborating with the Director in conducting leadership rounds to support workflow and staff engagement.
Development and oversight of CM work schedules/calendar management via API in accord- ance with the PTO policy.
Implement operational systems, processes and policies in support of care management programs' mission-- specifically, standardization of care, establishment of disease and population health metrics, and consistency of reporting, whole-person care integration,
information flow and management, job functions.
Evaluate clinical practice of specified discipline and review clinical records to ensure standards of care and quality of services are provided in accordance with DUHS
Will conduct employee 30/60/90 day evaluations as well as mid-year and end of year evaluations.
Ensures compliance with licensure and certification requirements of new and existing employees.
Provides education to support regulatory compliance in collaboration with DUHS Compliance and Population Health Management Office leadership.
Conducts Care Management te am meetings.
Participates in monthly CM departmental Meetings.
Provide education and feedback to provider groups as indicated.
Ensure adherence to all Population Health Management office and DUHS organizational policies .
Ensures adherence to regulatory compliance.
Promotes an environment of collaboration across the health system and throughout the community.
Attends and contributes to the Population Health management meetings and Committee meetings.
Will participate in the development and presentation of projects and education topics to staff, provider groups, community stakeholders, and post-acute care arenas as indicated.
In collaboration with the Directors and Human Resources, manages the recruitment, hiring, onboarding and retention of Care Management staff.
Develop the administrative framework required to support education and training, initiatives.
Evaluate and measure the effectiveness of training and development; align with
organizational business goals and objectives.
Collaborate with PHMO leadership to develop guiding principles, strategies and plans; conduct comprehensive needs assessments; determine education, training and development priorities based on assessed needs, business impact and available resources.
Provide consultation to manager colleagues for development of job-specific training.
Electronically document and/or monitor all activity in Maestro, and other documentation systems relevant to the position. In addition, provides any necessary follow-up interventions that may be required.
Establish any necessary agency Performance improvement activities.
Facilitate the team process including the interdisciplinary communication and negotiation skills.
Knowledge, Skills and Abilities
The work activity and patient acuity levels can create a demanding atmosphere, therefore individuals successful in this job are:
Experience with the care management continuum of care and execution of care management programs .
Ability to analyze data and employ approved management techniques.
Computer proficiency and experience with care management workflow systems.
Knowledge of information systems to support the evaluation of current capacity as well as future needs.
Strong communication and leadership skills.
Provide daily management of staff performance.
Knowledgeable of federal and state healthcare standards/regulations.
Considerable knowledge of large-scale health care facilities, policies, and issues.
Knowledge of payer requirements and quality measures that support the development of depart mental policies, procedures and standards.
Effective organizational, oral and written communication skills, problem solving, program development, and team building skills.
Ability to work with a variety of disciplines and levels of staff across departments, community, and the health system is required.
Ability to form positive, collaborative relationships with PHMO executive team and effectively negotiate with internal and external service providers.
Ability to establish priorities, meet deadlines, develop and manage the department's productivity standard in the management of the work assignment.
Work requires a bachelor's degree in a clinical field such as Nursing, Counseling, Social Work, Therapy, allied health, or community health related fields.
Work requires a minimum of five years of clinical experience, including EXPERIENCE OR ANY OTHER EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND/OR supervisory experience.
Degrees, Licensures, Certifications
Must have a current license in at least one of these areas: current or compact RN licensure in the state of North Carolina, current licensure as a licensed clinical social worker by the NC Social Work Certification and Licensure Board, current licensure as a licensed professional counselor by the state of NC, or current licensure as a licensed addiction specialist by the state of North Carolina. Requires ACM or CCM certification within 3 years of hire date.
Job Code: 00005593 MGR, POPULATION HEALTH CARE MGMT Job Level: G2
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