(Hybrid Georgia) Supervisor, Care Management

Summit Health•Atlanta, GA

4d•Hybrid

About The Position

This role oversees the performance of a group of care managers, care coordinators, and transitional care specialists within a value-based care model. The Supervisor of Care Management for the Georgia market is a full-time, exempt role reporting to the Manager of Care Management. They lead the provision of care management services, ensuring compliance with policies, regulations, and quality standards. The role may also involve filling in for a care manager when needed. The work involves actively engaging high-risk identified patients, developing patient-centered plans of care, and providing interventions to achieve patient self-advocacy and improved outcomes. Communication of assessment findings, care plan goals, interventions, and outcomes to PCPs, patients, and caregivers is crucial. The role also assists in utilization management by reviewing patient risk factors and utilization history, developing care plans for improved quality of life and decreased cost of care, and acutely managing high-risk patients post-discharge to decrease readmission risk and engage in longitudinal care management. Screening and referring patients to multidisciplinary care team members for physical and social health needs, identifying gaps in care and adherence, educating patients on preventative care, and mitigating barriers to gap closure are key responsibilities. Employing motivational interviewing skills for optimal member engagement and maintaining a core understanding of population health management for high-risk patients and the triple aim are also essential.

Requirements

Bachelor's degree required
Current licensure (RN) in the state of Georgia
3+ years of direct, clinical nursing experience
Minimum of 2 years of case management experience
Experience using EMRs related to documentation and reporting capabilities
Proficient use of technology including Microsoft suite of products

Nice To Haves

Certification in case management preferred
2 years of leadership experience preferred

Responsibilities

Manage each team member of the Transitional Care Management team through frequent communication, case reviews, performance evaluations, onsite assistance, and as a resource as needs arise
Lead orientation and training for new Transitional Care Management staff related to managing role/workflow expectations
Perform case reviews of RN CM peers evaluating policy/protocol adherence, interdisciplinary team collaboration, and utilization trends of engaged populations
Provide peer to peer feedback related to productivity and caseload management opportunities
Work collaboratively with market leadership to develop and refine workflows and processes representing clinical best practices
Represent CMs on established case review meetings for utilization management
Host team meetings for complex case reviews, workflow review and team building purposes
Travel to market clinics to meet with practice leadership, as requested, representing CM roles, functions, and opportunities to drive improved patient care
Ensure educational compliance of RN team members via LMS and annual compliance trainings
Monitor metrics and provide data (qualitative and quantitative) as requested by supervising director
Actively engage high-risk identified patients, develop patient centered plans of care and provide interventions to patient with the goal of achieving patient self-advocacy and improved outcomes
Communicate assessment findings, care plan goals, interventions and outcomes to PCP, patients and caregivers in a timely manner
Assist in utilization management by reviewing patients risk factors and associated utilization history and developing care plans aligned to improved quality of life and decreased cost of care
Acutely manage high-risk patients post-discharge, decreasing risk of readmission and engaging in longitudinal care management
Screen and refer patients to multidisciplinary care team members to ensure both physical and social health needs are met
Identify gaps in care and adherence, educate patients on preventative care and mitigate barriers to gap closure
Employ motivational interviewing skills to elicit optimal member engagement/outcome
Maintain a core understanding of population health management as it specifically relates to high-risk patients and the triple aim
Other tasks as defined by leadership