RN Case Management Manager-Internal Candidates Only

TrueCare • Vista, CA

1d

About The Position

TrueCare is a trusted healthcare provider serving San Diego and Riverside Counties, offering compassionate and comprehensive care to underserved communities. We are committed to making healthcare accessible to everyone, regardless of income or insurance status. With a focus on culturally sensitive, affordable services, TrueCare aims to improve the health of diverse communities. Our vision is to be the premier healthcare provider in the region, delivering exceptional patient experiences through innovative, integrated care. The Registered Nurse (RN Case Management (CM) Manager is responsible for managing Case Management clinical staff, and, within the scope of practice, performing nursing duties following established policies, procedures, and standards. The RN CM Supervisor is also responsible for ensuring that Case Management staff work effectively and efficiently in a care team setting with an emphasis on customer service and high-quality health care.

Requirements

• Bachelor’s degree in nursing, health administration, or a related field or an equivalent combination of education and professional experience relevant to the position.
• Graduate of an accredited California school of professional nursing.
• A minimum of three (3) years of clinical nursing experience in an outpatient care setting.
• A minimum of two (2) years of supervisory or management experience in a healthcare setting.
• A minimum of one (1) year of case management experience.
• Computer proficiency, particularly with electronic health/medical record systems and the Microsoft Office suite, including Outlook and Word.

Nice To Haves

• Bachelor of Science in Nursing (BSN) from an accredited institution.
• Bilingual in English and Spanish.

Responsibilities

• Under the direction of the Director of Case Management, use nursing standards, Patient-Centered Medical Home concepts, and other emerging health innovation models to develop work processes and approaches for implementing a centralized Care Management department.
• Monitor and prioritize workflow and schedules, to maximize provider and staff productivity, employee morale, and patient satisfaction.
• Monitor, coach, develop and evaluate the performance of staff on an ongoing basis in accordance with applicable performance standards; provide direct and timely feedback regarding daily operations and clinical skills competencies.
• Identify and implement opportunities to build employee morale and individual motivation.
• Oversee/monitor and assist in the training of new and existing employees.
• Provide ongoing training to employees as new processes or updates are implemented and work with employees to correct deficiencies.
• Shadow staff on skill competencies, as needed, to ensure proper workflow processes and procedures are followed.
• Track absenteeism, manage time off requests, and approve timesheets.
• Assist in preparation for and delivery of staff meetings and in-service and staff training, including monthly mandatory trainings.
• Assist in the preparation for audits conducted by various agencies.
• Serve as a point of contact for staff with questions, issues, or patient-related escalations. When unable to address issues, independently bring them to the attention of the Director.
• Provide supervision and support to case managers in the coordination of services for patients, especially those with complex, chronic health problems, abnormal screening, and/or psychosocial issues.
• Ensure staff patient panel workloads are assigned appropriately.
• Monitor and evaluate the effectiveness of care management activities, including responsiveness, and modify as necessary.
• Investigate and respond to client and provider complaints regarding quality of care as related to care management.
• Facilitate patient access to appropriate medical and specialty providers.
• Oversee the staff use of electronic documentation systems in compliance with standard TrueCare processes, with a standard documentation style that is aligned with Health Insurance Portability and Accountability Act (HIPAA) regulations.
• Implement, monitor, and audit timeliness and completeness of transitions of care.
• Promote multidisciplinary collaboration, provider relations, and engagement of family and caregivers to enhance the continuity of care for TrueCare patients.
• Work collaboratively with key leadership teams for the development and maintenance of clinically appropriate care management processes.
• Track and trend data to identify opportunities to optimize patient care in collaboration with related departments.
• Drive measurable improvement in chronic care management, population health, and clinical outcomes, while meeting requirements of regulatory agencies or payers.
• Establish and implement integrated continuous quality improvement process and customer satisfaction to assure high quality care, customer satisfaction, and contribution to financial performance.
• Ensure Care Coordinators are aligned with and follow the Team-Based Care model and strategic operational business goals.
• Assists care coordinator with patients as needed.
• Conduct and oversee completion of comprehensive, preventive screenings for patients and/or assist care coordinators in daily patient interactions, as needed.
• Maintain relationships with health plans to ensure comprehensive care for high-risk patients.

Benefits

• Competitive Compensation
• Competitive Time Off
• Low-cost health, dental, vision & life insurance
• The pay range for this role $104,827 to $162,482 on a salary basis.
• Pay transparency: If you are hired at TrueCare, your salary will be determined based on factors such as education, knowledge, skills, and experience. In addition to those factors, we believe in the importance of pay equity and consider the internal equity of our current team members when determining an offer.
• TrueCare is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of any characteristic protected by applicable federal, state, or local law.
• Our goal is to support all team members recruited or employed here.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 251-500 employees