Nurse Manager Complex Care Management

Nurse Manager Complex Care Management

Southwestern Health Resources-Clinically Integrated Network, (SWHR-CIN), is looking for a qualified candidate to join our team.

If you’re looking for a rewarding career at a patient-centered organization with work-life balance and comprehensive benefits, we want to hear from you.

Southwestern Health Resources (SWHR) is a patient-centered, clinically integrated network of 31 hospital locations and more than 7000 physicians and clinicians caring for more than 790,000 patients across 16 counties in North Texas. Blending the strengths of Texas Health Resources and the University of Texas Southwestern Medical Center, SWHR offers an unmatched ability to connect individuals with a full spectrum of nationally preeminent, clinical care. SWHR is the parent of Care N’ Care Insurance Co., a leading regional Medicare Advantage health plan that serves North Texas seniors.

At SWHR, we believe healthcare can be more integrated, accessible and affordable for all. Our purpose: to build a better way to care, together. Our promise: to simplify and empower care, for good.

• Work location: Southwestern Health Resources Headquarters, Farmers Branch, TX. Required in office once a week. Clinic visits in assigned zone and coverage in Tarrant County area.

Job Summary

Nurse managers provide the vital link between the administrative strategic plan and the point of care. The nurse manager is responsible for creating safe, healthy environments that support the work of the health care team and contribute to patient engagement. The role is influential in creating a professional environment and fostering a culture where interdisciplinary team members can contribute to optimal patient outcomes and grow professionally.

This position collaborates with the Director of Care Management to provide adequate staffing levels, appropriate learning experiences, professional work environment utilizing a team approach, and ongoing communication with the multidisciplinary team to ensure that SWHR provides high quality patient care in a cost-effective manner. The Nurse Manager’s responsibilities include hiring, terminations, performance management, disciplines, orientation, and conducting staff meetings.

Position Duties

Supports and guides care management functions in a fast paced, growth-oriented population health organization. Responsible for the development and execution of care management activities (including transition of care) to drive compliance with health plan partners’ models of care and contractual requirements.

Monitors care management clinical operations as well as contractual and regulatory operational requirements to drive compliance, quality outcomes and operational efficiencies. Responsible to support achievement of cost, quality, utilization, and patient/member experience goals.

Identifies and executes on best practices for member assessment, care plan development (as applicable), care management/care coordination, transitions of care and end of life care. Monitor performance quality and performance metrics while also providing recommendations on operational design and efficiencies

Effectively manages day-to-day functions to maximize time and achieve goals. Leads the care management team by ensuring they are effectively and efficiently operated, resourced, and performance managed accordingly. Monitors staffing, caseload, productivity, and budget for care management.
Participates in personnel management including recruiting, hiring, goal setting, evaluations, and team building. Supports initial and ongoing training development and facilitation for new and existing staff. Develops care management policies, procedures, and/or other job aides as needed. Develops performance improvement plans or other quality monitoring tools to support performance expectations for all staff.

Education
Bachelor’s Degree Nursing, or Healthcare Related field required
Master’s Degree Nursing, Social Work, Psychology, Health Administration, Public Health or other relevant Master’s preferred.

Experience
5 years ACO, Health Plan or Provider care management experience required to include 3 years previous experience in a manager or supervisor role required.
2 years experience with Medicare Advantage, Bundled Payments, Direct Contracting and/or CSNP/DSNP programs preferred.

Licenses and Certifications
RN – Registered Nurse Active RN License required upon hire
CCM – Certified Case Manager preferred upon hire.

Skills
Data analytic skills required. Able to review data and make recommendations and formulate action plans in response to data findings
Strong professional organizational, interpersonal skills and critical-thinking skills required for effective and creative leadership.
Strong communication, customer service and decision making skills; standards of care, and regulatory standards required.
Proven leadership experience that includes team building, motivating staff with enthusiasm and compassion, communicating skills across disciplines
Possess good analytical and problem-solving skills.
Proven success in teambuilding and training / coaching staff to meet operational requirements and goals.
Ability to work with computerized clinical information systems.

Travel Requirements
Manager may be asked to attend meetings at practice locations and/or parent organizations

Why Southwestern Health Resources

As a Southwestern Health Resources you’ll enjoy: comprehensive benefits, including a 401(k) with match; paid time off; competitive health insurance choices; healthcare and dependent care spending account options; wellness programs to keep you and your family healthy; tuition reimbursement; a student loan repayment program; and more.

Explore Southwestern Health Resources Careers for more information and to search all career opportunities.

Let’s move healthcare forward – together.