Care Management (CM) Manager

Kaniksu Community Health•Sandpoint, ID

1d•Onsite

About The Position

Kaniksu Community Health is a non-profit, award-winning Community Health Center providing integrated, team-based healthcare in North Idaho. We are committed to providing quality, accessible, approachable, and affordable healthcare for everyone, regardless of their ability to pay or the severity of their concerns. We operate under the Patient Centered Medical Home model of care, offering comprehensive and integrated multi-disciplinary services. We are also invested in our employees, striving to provide opportunities for them to learn, grow, and thrive in a positive and engaged team environment with a "family" spirit. The Care Management (CM) Manager is an essential team member responsible for providing excellent customer service and an excellent patient experience while performing essential clinical or administrative work in a fast-paced, productive environment. This role involves assisting patients in managing their care at Kaniksu Community Health, working under the direction of the KCH Director of Nursing, Director of Clinical Operations, and Medical Staff Providers as part of the Kaniksu Community Health Patient Centered Medical Home (PCMH) Team.

Requirements

Bachelor's degree in Nursing, or a related field required.
Minimum of three to five years of experience in care management, case management, population health, or a related healthcare setting.
Experience working with regulatory requirements, quality improvement, and program compliance.
Current, unrestricted Registered Nurse (RN) or Licensed Practical Nurse (LPN) license in the State of Idaho.
Strong knowledge of care management principles, population health, and care coordination models.
Understanding of healthcare regulations, quality standards, and compliance requirements.
Ability to balance direct patient care responsibilities with leadership and administrative duties.
Strong leadership, coaching, and team development skills.
Excellent communication, organizational, and problem-solving abilities.
Proficiency with electronic health records and data reporting systems.
Ability to analyze performance metrics and implement process improvements

Nice To Haves

Minimum of two years of supervisory or leadership experience preferred.
Certified Case Manager (CCM) or related certification preferred.

Responsibilities

Maintain a reduced patient panel and provide direct care management services to assigned patients.
Conduct patient assessments and develop individualized care plans.
Coordinate care across providers, community resources, and support services.
Monitor patient progress and outcomes, adjusting interventions as needed.
Document patient interactions and care plans in accordance with organizational and regulatory requirements.
Support patients in achieving health goals and improving self-management skills.
Provide day-to-day leadership and oversight of the Care Management Program.
Ensure program operations align with organizational objectives, quality standards, and regulatory requirements.
Monitor program performance metrics and implement process improvements to enhance outcomes and efficiency.
Develop and maintain policies, procedures, and workflows that support effective care management services.
Collaborate with clinical and operational leaders to ensure integrated patient care and program success.
Ensure compliance with all applicable federal, state, payer, and organizational requirements.
Monitor documentation quality, productivity, and program performance standards.
Conduct regular audits and quality reviews to identify opportunities for improvement.
Implement corrective actions and continuous quality improvement initiatives as needed.
Prepare reports and support accreditation, regulatory, and payer audits.
Provide supervision, coaching, and support to care management staff.
Participate in recruitment, onboarding, training, and retention efforts.
Conduct performance evaluations and provide ongoing feedback to team members.
Identify training needs and coordinate professional development opportunities.
Foster a positive, collaborative, and patient-centered team culture.
Serve as a liaison between care management staff, providers, leadership, and community partners.
Participate in interdisciplinary meetings and case reviews.
Communicate program updates, priorities, and performance expectations to team members.
Support organizational initiatives and strategic goals related to population health and care coordination.