Nurse Manager, ACO Care Management Program

Greater Lawrence Family Health Center•Methuen, MA

42d

About The Position

Established in 1980, the Greater Lawrence Family Health Center (GLFHC) is a multi-site mission-driven non-profit organization employing over 700 staff whose primary focus is providing the highest quality patient care to residents throughout the Merrimack Valley. Nationally recognized as a leader in community medicine (family practice, pediatrics, internal medicine, and geriatrics), GLFHC has clinical sites throughout the service area and is the sponsoring organization for the Lawrence Family Medicine Residency program. The Nurse Manager of Care Management Program works under the supervision of the Director of Population Health and is responsible for the daily oversight and operations of the C3 ACO Care Management program. The Manager ensures care management processes are in compliance with the ACO delegated agreement. This program supports enhanced care coordination for MassHealth ACO members across pediatric, adult, and maternal populations. The Manager provides leadership and operational direction to an interdisciplinary team consisting of RN Care Managers, Behavioral Health Care Managers, and Community Health Workers, ensuring services are delivered in a high-quality, cost-effective and patient centered manner. The Manager is required to have a proficient understanding of MassHealth and CMS requirements to ensure care management workflows are implemented, in compliance with these standards.

Requirements

Bachelor's degree in nursing with Massachusetts RN Licensure.
3-5 years of management experience in care management within a managed care environment.
Experience working with Medicaid and vulnerable populations, including those with chronic medical, behavioral, and social needs.
Demonstrated success in leading a multi-disciplinary team, including collaboration with providers, integrated care teams, nurses, community health workers, and other organizations such Social Service Organizations (SSO) and Community Partners (CPs).

Nice To Haves

Case Management certification desirable but not required.

Responsibilities

Oversee daily operations of the Care Management Program, ensuring alignment with C3 ACO delegation agreement goals, MassHealth, and CMS requirements.
Under the direction of the Director, takes lead in revising necessary workflows in order to comply with contract amendments, corrective action plans, and other contract revisions.
Monitor and Assess team performance using program metrics, data, and management reports to assess caseloads, engagement rates, outcome, and other process measures.
Utilize data-driven insight to identify opportunities for improvement, implement performance enhancement strategies, and maintain high standard of care delivery.
Collaborate with the Director of Population Health to plan, monitor, and report on performance improvement initiatives and staff development needs.
Conduct regular chart audits, provide both individual and group supervision, and complete performance reviews, including mid-year and annual goal setting.
Ensure all staff are informed of updated policies, procedures, and workflows, and that these align with current regulatory and program requirements.
Develop and deliver training content to enhance staff competency, incorporating updates to workflows and best practices.
Maintain expertise in technology platforms that support care management, including care coordination tools and Health-Related Social Needs (HRSN) screening systems
Facilitate care management clinical rounds and participate in care management clinical forums.
Manage operational needs, including recruitment, onboarding, training, scheduling, and coverage planning to ensure optimal staffing levels.