Care Management Operations Specialist

Visiting Nurse Service of New York d/b/a VNS Health • New York, NY

4d

About The Position

Manages and coordinates the operational and project management functions supporting Care Management and related clinical operations. This role ensures that departmental projects and day-to-day operations are executed efficiently, compliantly, and in alignment with organizational goals. Responsibilities include developing and optimizing workflows, managing staff, leading key initiatives, and collaborating with internal and external partners to enhance service quality, efficiency, and member outcomes.

Requirements

• Bachelor's Degree in Business, Nursing, Healthcare or other related industry, or the equivalent combination of work and experience required or
• Master's Degree in Social Working required
• Minimum five years progressive management experience preferably in a customer service or health care environment required
• Proficient in Personal Computers applications, including Microsoft Word and Excel required
• Knowledge of medical terminology, pharmacology information and /or insurance terminology required
• Strong knowledge of operations of manual and automated office systems and procedures required
• Strong operational skills with attention to detail required
• License and current registration to practice as a Registered Professional Nurse in the state of New York required for RNs preferred or
• Current registration to practice as a Licensed Master Social Worker (LMSW) in New York State preferred

Nice To Haves

• Strong knowledge of third-party payer requirement for reimbursement preferred

Responsibilities

• Manages day-to-day operations of Care Management functions, ensuring compliance with internal procedures and external regulatory requirements.
• Oversees operational performance metrics and implements process improvements to optimize care delivery and administrative efficiency.
• Leads and coordinates departmental projects from planning through implementation, defining scope, timelines, and deliverables.
• Manages and provides oversight to Care Management Operations, including project coordination and operational activities that support departmental goals.
• Tracks and monitors project milestones and department workflows to ensure timely completion of goals.
• Manages meetings, workgroups, and training sessions in support of departmental initiatives.
• Identifies, designs, and implements process improvements and performance initiatives across Care Management Operations.
• Serves as liaison between Care Management leadership, analytics, IT, and other departments to ensure cross-functional collaboration.
• Develops dashboards, progress reports, and analytical tools to monitor performance and outcomes.
• Supports development and rollout of new programs, technologies, and systems to enhance Care Management operations.
• Provides regular reports and presentations to leadership on progress, outcomes, and key initiatives.
• Ensures operational and project deliverables are achieved on time, within scope, and aligned with regulatory and quality standards.
• Delivers measurable improvements to performance metrics, efficiency, and member and provider satisfaction.
• Resolves multifaceted issues that require consideration of clinical, operational, and strategic factors, drawing upon advanced knowledge of healthcare operations and project management best practices.
• Oversees and manages complex operational and project management functions that require knowledge of care management workflows, data analysis, and continuous improvement methodologies.
• Participates in special projects and performs other duties as assigned.

Benefits

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees