Clinical Manager Jobs

About The Position

Requirements

• Bachelor degree in nursing or a health-related field.
• Current active license/registration in New York State as applicable and additional state licenses/registration (NJ, CT, etc.) as required by Program.
• 5 years of clinical practice, preferably including at least 2 years in an outpatient setting.
• Minimum 2 years of supervisory experience.
• Knowledge of Medicare & Medicaid benefits and guidelines.
• Knowledge of case management concepts.
• Knowledge of quality improvement techniques.

Nice To Haves

• Masters degree preferred.
• Medical Management experience in a managed health care setting preferred.
• Professional certification in Case Management, Utilization Management, or Quality Management preferred.

Responsibilities

• Oversee day-to-day operations of multidisciplinary teams for program implementation.
• Supervise nursing, social work, administrative, and other professional staff.
• Ensure actions are consistent with policies, procedures, and automated systems (EPIC, CIS, tele-monitoring devices).
• Assist in the development of policies, procedures, and work flows.
• Monitor workflow and staff effectiveness.
• Ensure appropriate interventions are offered to enrolled beneficiaries and members.
• Assist in program monitoring.
• Identify and assist in resolving barriers to successful implementation of Care Management/Utilization Management Programs.
• Support staff development and training.