$10,000* SIGN ON BONUS!! ACO Clinical Care Manager (ADMIN)

The ACO Clinical Care Manager is accountable for the development, implementation, operation, evaluation, and enhancement of clinical services programs focused on the provision of care management within the Outpatient, Ambulatory Clinical and medical practice settings and works collaboratively with the Inpatient Care Managers and ACO Director. This person will support CHP’s mission, vision, and values and will adhere to compliance protocols as well as CHP’s policies and procedures.

            *Bonus prorated based on number of committed work hours upon hire*

ACO Clinical Care Manager Essential Duties and Responsibilities:

• Lead, mentor and supervise staff:
  • Responsible for the recruitment, orientation, evaluation, coaching, counseling, and disciplinary action of care management clinical and administrative staff.
  • Monitors staff effectiveness and collaborates with ACO Director in facilitating professional development and celebrating achievements.
  • Onboards new Care Management staff and facilitates training and development processes to ensure staff are set up for success.
  • Develop individual staff educational plans and implementation of annual training for skill and career development of staff.
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  Manages operations to ensure optimal program performance:
  • Manages and assumes responsibility for oversight of day-to day-operations of ambulatory Care Management including population health management, care coordination, case management, and discharge planning activities.
  • Manages process of population health screening and stratification to identify patients for appropriate care interventions.
  • Performs outreach and education to referral sources: ensure appropriate triage, oversee care management activities, and referral source communication and workflow.
  • Monitors program effectiveness, identify opportunities for improvement, and assist director in enhancement strategies.
  • Supports budget development and management of resources within budget parameters.
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  Provides clinical support:
  • Reviews cases regularly with staff; acts as clinical consultant regarding care management issues; guides clinical staff with review of assessments and care plans; evaluate documentation.
  • Performs monthly audit of charts on care management activities, including discharge planning, to identify patient-specific and staff-specific opportunities to enhance health outcomes.
  • Participates in daily patient huddles and supports staff in prioritization and problem solving.
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  Establishes and maintains effective collaborative relationships with system and external colleagues:
  • Works collaboratively with inpatient and outpatient providers to assure effective transitions of care.
  • Collaborates with the Director of Inpatient Care Management on programs and projects that improve the care and experience of the patient across the continuum of care.
  • Provides relief coverage of inpatient care management.
  • Participates in strategies to decrease patients with frequent ED utilization and readmission.
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  Ensures compliance with requirements:
  • Assist ACO Director in establishing, implementing, and ensuring that care management policies, practices and procedures are in accordance with the Joint Commission, and other regulatory agencies and overall hospital policies.
  • Oversee submission of any audits, including but not limited to Medicaid, Medicare, and internal compliance studies.
  • Excellent interpersonal skills and abilities in relating to people at all levels to represent CHP professionally and negotiate, sell, motivate, and coach successfully.
  • Retains administrative oversight for Care Management. Provides specific direction for personal growth to management and lead staff. Utilizes CHP values and strategic goals to drive performance.

Competencies: To perform the job successfully, an individual should demonstrate the following competencies:

• Excellent verbal and written communication.
• Excellent multi-tasking, communication, and organization skills.
• Detailed oriented.
• Ability to understand people and situations.
• Ability to provide people-centered care.
• Ability to improve nursing quality.
• Behave ethically and professionally.
• Work with diverse populations.
• Collaborate well with others.

Essential Skills and Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Experience:

• • Five years of clinical experience in a directly related setting (outpatient clinical setting}
  • Three years of case management / social work experience.
  • Two years of experience in a supervisory/management or lead role.
  • Certification in Case Management preferred.
  • Previous direct experience in managing or leading government/ACO programs preferred.
  • Previous direct experience with MassHealth, programs preferred.
  • Previous experience with behavioral health and substance use disorder preferred.

Education and Training:

• Bachelor’s Degree in Nursing and/or related healthcare discipline required.
• Master’s Degree in nursing is preferred.
• Master’s Degree in Social Work required. (If qualifying via the LICSW requirement below)
• Understanding of patient-centered care principles, population health management, stages of change, self-determination

License, Certification & Registration:

• RN/LICSW - RN License/BS degree or LICSW in MA.
• Certification in Care Management is preferred
• Current CPR certification required.