AdvantageCare Physicians-posted 3 months ago
$113,400 - $210,600/Yr
Full-time
Remote • New York, NY
1,001-5,000 employees
Ambulatory Health Care Services

The position involves assisting in leading the strategic development of analytics and business intelligence to support population health and market growth initiatives. The role requires collaboration with the AVP of Care Management and ACPNY leadership to operationalize the Care Management strategic plan. The individual will work collaboratively with ACPNY partners to prevent avoidable emergent care visits and re-hospitalizations. Responsibilities include selection and hiring of qualified staff, ensuring effective onboarding, and providing ongoing comprehensive training and regular feedback. The role also entails managing day-to-day operations and performance in collaboration with the APNY team, AVP of Care Management, and Field Based Care Managers, providing services to EmblemHealth members at ACPNY location sites. The individual will visit field sites to build relationships with ACPNY colleagues and EH Care Management staff, provide education, coaching, and mentoring to team members, and use problem-solving abilities to create solutions to operational and clinical issues. Additionally, the position serves as a link between the Plan's staff and its internal and external customers to promote and improve communication of initiatives relative to Care Management, address audit-related findings, and implement performance improvement strategies. The individual will also collaborate with other functional areas within the organization to ensure compliance with policies, procedures, and regulatory mandates, and will be responsible for data collection needed to report on program metrics, overseeing HEDIS/STARS and NCQA requirement responsibilities of the Care Management team.

  • Manage daily operations of the Care Management team, defining metrics and measuring performance against standards.
  • Deploy strategies to improve performance and productivity.
  • Train employees in process operations and act as a preceptor to newly hired staff.
  • Complete quarterly evaluations of staff as needed.
  • Monitor team caseloads and shift workloads to meet departmental needs.
  • Monitor documentation in clinical systems to ensure compliance with accreditation and regulatory standards.
  • Ensure team members manage enrollees across the care continuum, including behavioral health.
  • Serve as a clinical resource and attend Care Management rounds.
  • Monitor employees' performance regularly and provide coaching as needed.
  • Bachelor's degree, preferably in Nursing.
  • Current unrestricted New York State RN license required.
  • CCM certification required, but consideration will be given for current enrollees/candidates.
  • 10+ years of relevant work experience, preferably with a healthcare provider.
  • 5 years of clinical experience.
  • Health plan experience highly desirable.
  • Familiarity with Population Health Management.
  • Experience leading care management teams.
  • Strong problem-solving skills.
  • Detail-oriented and organized.
  • Excellent written and oral communication skills.
  • Strong working knowledge of Microsoft products including Excel and PowerPoint.
  • Strong problem-solving and strategy execution abilities.
  • Hiring Range: $113,400-$210,600
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