Clinical Care Partnership - Manager - Springfield, MA. Full-time 

Mid-level Hospital/Health Care $79,000 – $120,000 Medical Ins. Dental Ins. Vision Ins. Life Ins. Retirement Equity 

Paid Time Off OFCCP Required - Travel Up to 20% of the time - Visa Applicant must be a U.S. citizen or a current Green Card holder 



Must-Haves 

Strong Clinical Background: NP, PA preferred, RN acceptable 

Strong people management in healthcare arena 

Previous leadership experience 

Experience developing metrics and holding accountability 

Stable employment history

Nice-To-Haves 

Bilingual: Spanish, Portuguese, Russian, Nepalese, and Vietnamese 

Visiting Nurse background 

Forward, progressive and process thinker 

Development of workflows 

Nursing home experience not applicable 

Description of Duties 



The Manager will play a vital role in the success of the entire Care Partnership organization. The main expectation of the Clinical Manager is to be accountable for the performance of the team, by ensuring that all key performance metrics are met as well as the team’s daily operations, including the member experience, care management, care coordination, and care delivery. The Clinical Manager will ensure that the team meets clinical and health plan related KPI’s (Key Performance Indicators) which are set by clinical leadership, regulators, and the business. Care Partner Team is primarily responsible for providing longitudinal care coordination, care management, and care delivery to a dedicated panel of dually-eligible, a group of individuals with significant medical, behavioral, and social complexities.

 

As a keystone of the Clinical Group leadership team, the Manager, Clinical Care Partnerships participates in the development of tactics and is responsible for the execution of strategies to meet objectives. The Manager is engaged in the hiring and onboarding, performance management and staff enablement to support and improve care delivery, care management, and clinical operations in alignment with the strategic goals.



RESPONSIBILITY:

• Leads a team, comprised of Telephonic RN’s, Mobile RN’s, and Mobile NP’s.


• Holds team accountable to meet Key Performance Indicators, proactively identifies areas of opportunity and improvement for individual contributors, creates action/development plans for individual contributors and follows through on plans.


• Ensures that work is evenly distributed across the team, collaborates with other clinical managers to ensure even distribution across teams. 


• Accountable for quality and financial outcomes, service utilization, targeted case mix and productivity levels of Care Partners. 


• Collaborates closely with Behavioral Health leadership to ensure appropriate integration within the team. 


• Models collaboration with other “specialties” including palliative care, women’s health, diabetes management, and the medical directors. 


• Active participant in Medical Management initiatives, working toward goal of impacting the cost of health care for the dual eligible population. 


• Is responsible for the Root Cause Analysis process within the team, reviewing all inpatient medical hospitalizations to identify areas of opportunity and improvement for individual contributors. 


• Reviews service plans to ensure “right sizing” by identifying areas to impact financial outcomes. 


• Depending on licensure level, may collaborate with Clinical Director on this process.


• Participates in the selection, hiring, and onboarding of staff as well as performance appraisal, documentation of deficiencies, performance recognition, and disciplinary action.


• Develops, supervises, and appraises direct reports; plans and implements disciplinary actions as needed, works with Human Resources and legal staff as appropriate; when warranted, makes recommendations to the Clinical.


• Director regarding the evaluation, promotion, transfer or discipline of personnel.


• Leverages resources across the team as needed to serve our members. 


• Provides clinical guidance and coaching for complex situations.


• Addresses internal personnel issues, problem-solves local issues and engages in conflict management. 


• Provides clinical guidance and coaching for complex situations throughout the team. 


• Acts as mentor and coach to new Clinical Managers.


• Leads team meetings and selective (audit oriented) high risk case reviews). 


• Lead re stratification discussion to ensure members are in the correct care model. 


• Provide oversight over new hire orientation in close collaboration with Education Department. 


• Prepares and analyzes reports to manage patient care and team performance. 


• Reviews clinical documentation and records to ensure accuracy and timeliness. 


• Provides input to Clinical Director and senior leadership into strategies to improve the performance. 


• Works cross-functionally within the organization to overcome barriers to effective and efficient local work flows.


• Participates in cross-organizational working groups to continuously improve practice. 


• Develops, refines, and enhances clinical programs, initiatives, processes, policies, workflows, and projects. 


• Participates in Quality Improvement efforts.


• Participates in committees and workgroups that promote clinical excellence and help to advance mission and business objectives. 


• Actively participates in the evaluation of own performance and progress.

QUALIFICATIONS:

• Bachelor's Degree in Nursing.


• RN, NP, PA with licensure in good standing in Massachusetts, NP or PA strongly preferred.


• 7+ years of related clinical experience.


• 5+ years of management experience or combination clinical / management experience. 


• Experience with cross-functional collaboration for process improvement. 


• Strong management and team-building skills. 


• Ability to manage significant change. 


• Excellent communication skills.


• In-depth knowledge of resources, clinical guidelines, systems, and processes preferred.


• Ability to teach, mentor, and coach across disciplines. 


• Ability to quickly shift gears and move in a new direction without clear guidance.


• Experience with electronic medical record strongly preferred (eCW a plus).


• Fluency in English required; fluency in one or more of the following languages strongly preferred: Spanish, Portuguese, Russian, Nepalese, and Vietnamese.