Nurse Manager

Family Health CenterWorcester, MA

About The Position

The Nurse Manager of Population Health provides clinical and operational leadership for programs focused on improving health outcomes, care coordination, quality performance, and cost of care across attributed patient populations. This role oversees nursing and interdisciplinary care management teams, supports value-based care initiatives, and leads strategies to improve preventive care, chronic disease management, transitions of care, and utilization management. The Nurse Manager partners closely with providers, behavioral health, community health workers, quality, and operational leadership to ensure coordinated, patient-centered care delivery across the continuum.

Requirements

  • Current Registered Nurse license in Massachusetts
  • Bachelors of Science in Nursing (BSN)
  • 3-5 years of clinical nursing experience
  • 2+ years of leadership or supervisory experience
  • Strong knowledge of quality metrics and value-based care metrics

Nice To Haves

  • Masters degree in Nursing, Public Health, Healthcare Administration, or related field
  • Certification in Case Management or Ambulatory Care Nursing
  • Experience in an ACO, FQHC, or managed care setting
  • Preferred experience in care management, ambulatory care, chronic disease management, or population health

Responsibilities

  • Lead and supervise nursing staff within population health and care management programs
  • Provide clinical oversight for complex patient care coordination and case management
  • Support evidence-based interventions for high-risk and rising-risk populations
  • Ensure compliance with nursing standards, regulatory requirements, and organizational policies
  • Serve as a clinical resource for staff managing medically and socially complex patients
  • Manage day-to-day operations of population health nursing workflows
  • Develop staffing models, schedules, and productivity expectations
  • Oversee transitions of care processes including post-discharge follow-up
  • Lead initiatives to reduce avoidable ED visits, admissions, and readmissions
  • Drive performance on quality measures including HEDIS, ACO, MSSP, and payer-specific metrics
  • Monitor dashboards related to chronic disease outcomes, preventive screening, and utilization
  • Collaborate with quality teams to improve benchmarks for diabetes, hypertension, behavioral health, and preventive services
  • Use data analytics to identify trends and prioritize interventions for target populations
  • Hire, onboard, coach, and evaluate nursing and care management staff
  • Conduct regular performance reviews and professional development planning
  • Foster a collaborative, patient-centered team culture
  • Support training in motivational interviewing, care management documentation, and risk stratification workflows
  • Partner with PCPs, specialists, behavioral health clinicians, CHWs, pharmacists, and social workers
  • Collaborate with finance and contracting teams on value-based care initiatives
  • Participate in payer meetings, quality committees, and operational leadership forums
  • Support community partnerships addressing social drivers of health
  • Participates in the development of new services, care delivery models, and digital applications.
  • Creates a supportive, team-based environment that facilitates group decision making and employee empowerment
  • Ensures that all patients, community members and FHCW workforce members are always treated with dignity and respect.
  • Works with the operational and clinical leaders to ensure the organization demonstrates a professional atmosphere and a culture resulting in positive relations between and among the healthcare team, patients and the public
  • Resolves conflicts and ensure that all employees perform their functions in a manner consistent with organizational values, policies, procedures, and best practices associated with their respective disciplines.
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