Nurse Manager (Case Management)

Salt River Pima-Maricopa Indian Community•Scottsdale, AZ

4d•Onsite

About The Position

Under the general supervision of the Nurse Administrator, the Nurse Manager (Case Management) will oversee the day-to-day operational needs of the River People Health Center Case Management Department. This includes ensuring that RN Case Managers coordinate care to optimize patient outcomes, enhance the patient experience, and increase the delivery of recommended preventative services for the patients served by the Community. The Case Management Nurse Manager will be responsible for adherence to budget and monitoring productivity to support various departmental needs, scheduling staff, and record keeping. This job class is treated as FLSA Exempt.

Requirements

Active AZ Registered Nurse license from an accredited college or university and certification as a Registered Nurse (RN) required.
Current Arizona or Multistate Registered Nurse license required.
Five (5) years’ work experience as a Case Management Registered Nurse (RN) required, including one (1) year of RN Case management experience in a primary care setting.
Two (2) years of nursing supervisory/management experience.
CCM Certification required.
Knowledge of the history, customs, culture, traditions and government of the Salt River Pima- Maricopa Indian Community.
Knowledge of regulatory standards of Registered Nurses in an ambulatory clinic setting.
Skill in the use of central sterile processing equipment, computer, copy machine and other essential office equipment.
Skill with verbal and written communication and the ability to communicate effectively with a wide range of people, clients, families, community groups and health professionals.
Skill managing various employee types in stressful situations.
Ability to use effective conflict resolution skills.
Ability to quickly mediate and resolve issues in a respectful manner and in an environment where staff are in a potentially reactive position.
Ability to establish and maintain positive and effective working relationships with colleagues, subordinates, supervisors, health care professionals, Tribal officials, representatives or resource agencies, patients and Community members.
Ability to use effective time management skills, including simultaneously oversee numerous aspects of the day-to-day operation, effectively prioritizing tasks, making and adhering to deadlines, and assisting other staff with their work.
Ability to deal with sensitive issues and maintain appropriate, professional and confidential relationships.
Ability to incorporate cultural differences, health beliefs and learning styles.
Ability to develop and implement program protocols as well as identify and address programmatic problems.

Nice To Haves

Continuing education and professional development in advancing chronic complex care preferred.
Experience working with Native Americans population strongly preferred.

Responsibilities

Management/Leadership: Responsible for management and oversight of the Care Management Programs including Transitional/Ambulatory/Chronic subsets of Case Management population. Directly responsible for daily operations of the Program and Department and for operational partnership with Community Health Resource Service, Benefits Coordination and Purchased Referred care. Oversees Lead interdisciplinary care conferences between transition and complex case managers and conducts regular case reviews with care management staff of complex and/or high acuity cases. Oversees Clinical Case Management Liaison engagement with partnered clinical facilities and providers to optimize the management of patient with complex care needs. Oversees Utilization Review RN CM and Referral Coordination Team. Provide oversight and supervision in the planning, development, implementation, and evaluation of quality improvement initiatives within the Case Management Department. Ensure staff are fully trained and adherent to established documentation standards. Prepares shift schedules and coordinates time off, process weekly time. Resolving conflicts among staff and between staff and RPHC personnel. Overseeing daily operations of the department and ensuring optimal use of everyone’s time and skills. Develops staff goals and objectives for evaluation, evaluates performance of assigned department staff and conducts timely performance evaluations (EPAR’s). Observes policies, procedures and guidelines with respect to the HHS and RPHC’s protocols. Ensures staff are qualified and trained with tools to support successful execution of their duties, Assigns and directs the daily workflows and associated clinic area activities.
Case Management: Coordinate and manage care of patients designated as from low, rising and high risk for progression of disease, clinical decline, and in need of urgent or emergent care. Works in collaboration with other Medical Management Departments to ensure optimal clinical outcomes, appropriate resource utilization, quality patient care, and high patient satisfaction. Ensure all patient interactions will be conducted in accordance to HIPPA regulations to maintain patient confidence and protect confidential information. Ensures that RN Case Managers work in collaboration with the primary and/or specialty physicians, healthcare team and the patient to provide coordination of care to those patients with complex and/or high risk conditions. Ensures the Case Management Departmental staff verifies identification of patients, provides screening, assessment, planning, implementation, coordination, monitoring and evaluation of health care services provided to the high risk population. Collaborate with other organizational departments responsible for functional aspects including, but not limited to Community Health Resources, Behavioral Health, Benefits Management, Quality Management, Information Systems, Finance, Claims.
Program Operations/Protocols: Develops and maintains processes to oversee ambulatory case management including standardized documentation and auditing, programs that maximize quality, programs to ensure appropriate resource utilization within patient benefit plan and established contracts. Contribute to the development and maintenance of an effective evaluation and monitoring system and utilize a variety of reports for staff coaching and program improvement. Participate in committees, as assigned. Ensures the goal of the program is optimizing patient outcomes, enhancing the patient experience, avoiding preventable inpatient admissions/readmissions, avoiding preventable/non-emergent emergency department visits, and increasing the delivery of recommended preventative service. Participate in the writing and interpreting HHS & RPHC policies and procedures Follows all departmental and Community policies and procedures. Maintains department direction with River People Health Center objectives on standards of operations including monitoring productivity and revenue projections. Maintain current and updated professional knowledge and proficiency of the scope of service of Case Management department through continuing education, staff meetings, training and conferences, etc.
Miscellaneous: Performs other job-related duties as assigned to maintain and enhance departmental operations.