Remote Entry-Level Nursing Role - Care Management ID-9069
Job Description
The Clinical Nurse for Care Management is responsible for the mentoring, training and clinical supervision of care management staff and oversight of staff caseloads of enrollees who have mild to complex medical and mental/behavioral health needs. This position has a broad knowledge base related to the needs of the Medicare and Medicaid population and is an integral member of the Care Management Leadership team. The Clinical Supervisor of Care Manager supports the operations of the Care Management Department through monitoring the staff's adherence to quality and productivity standards; assisting with responding to patients’s needs; and providing clinical supervision and leadership for compliance and performance improvement.
Other Jobs You May Be Interested In
Remote Data Entry, No Experience, $40/hr, Part-TimeVirtual Assistant, $45/hr, Remote, No Experience, Night Job
Entry-Level Remote Data Entry, $50/hr, Evening Job
Customer Support, No Degree, $40/hr, Remote, Weekend Job
Remote Phone Job, $42/hr, Part-Time, College Student Friendly
Virtual Assistant, $40/hr, Remote, No Degree, Night Job
Part-Time Data Entry, $45/hr, Remote, College Student Friendly
Remote Moderator, No Degree, $50/hr, Evening, Weekend Job
Remote Customer Support, $42/hr, Night Job, No Experience
Live Chat Support, $40/hr, Remote, Entry Level, Part-Time
Virtual Assistant, Remote, $42/hr, Weekend, No Experience
Remote Data Entry, $45/hr, No Degree, Night Shift
Part-Time Customer Support, $40/hr, Remote, College Student
Remote Live Chat, $50/hr, Part-Time, Evening/Night Job
Entry Level Phone Job, $42/hr, Remote, No Degree Required
Weekend Data Entry, $45/hr, Remote, No Experience
Remote Virtual Assistant, $40/hr, Evening, Part-Time Job
Remote Moderator, $42/hr, Part-Time, Weekend, No Degree
Data Entry, $45/hr, Remote, Night Shift, College Student Job
Phone Support, Remote, $50/hr, No Experience, Part-Time
Virtual Assistant, No Experience, $42/hr, Remote, Weekend
Remote Customer Support, $45/hr, Part-Time, College Student
Data Entry, Remote, $40/hr, Night Shift, No Degree
Evening Virtual Assistant, Remote, $45/hr, No Experience
Weekend Customer Support, $42/hr, Remote, College Student
Remote Data Entry, $50/hr, No Experience, Evening/Night Job
Remote Live Chat, $40/hr, Part-Time, No Degree Required
Virtual Assistant, $42/hr, Remote, Weekend, Entry Level
Remote Phone Support, $45/hr, Evening, No Experience Required
Data Entry, No Experience, $50/hr, Remote, College Student
Remote Moderator, $40/hr, Weekend, No Degree, Part-Time
Live Chat Support, Remote, $42/hr, Night Shift, College Student
Phone Job, $50/hr, Remote, No Degree, Part-Time, Weekend
Data Entry, $45/hr, Remote, Evening, No Experience Required
Virtual Assistant, No Experience, $42/hr, Remote, Part-Time
Remote Customer Support, $50/hr, Night Shift, No Degree
Remote Data Entry, $40/hr, College Student Friendly, Part-Time
Live Chat Support, $42/hr, Weekend, Remote, No Degree
Virtual Assistant, Remote, $45/hr, Evening, No Experience
Remote Phone Job, $50/hr, College Student, Night Shift
Remote Moderator, $42/hr, Weekend, No Experience Required
Data Entry, No Degree, $45/hr, Part-Time, Remote Job
Customer Support, $50/hr, Remote, Evening/Night Job, No Degree
Virtual Assistant, $42/hr, Remote, Weekend, No Degree
Remote Live Chat, $45/hr, College Student, No Experience
Remote Data Entry, $40/hr, Part-Time, No Degree Required
Phone Support, $50/hr, Weekend, Remote, No Experience
Virtual Assistant, $42/hr, Evening, Remote, No Degree
Remote Customer Support, $45/hr, No Experience, Part-Time
Data Entry, $50/hr, Night Job, No Degree, Remote
Remote Moderator, $40/hr, College Student Friendly, Part-Time
Virtual Assistant, Remote, $42/hr, Weekend, No Experience
Remote Phone Job, $45/hr, Part-Time, No Degree Required
Customer Support, $50/hr, Night Job, Remote, No Experience
Data Entry, Remote, $42/hr, Evening Job, No Degree
Live Chat Support, $45/hr, Weekend, Remote, College Student
Virtual Assistant, Remote, $50/hr, Part-Time, Night Shift
Data Entry, $40/hr, No Experience, Remote, Weekend Job
Remote Phone Job, $45/hr, No Degree, College Student Friendly
Customer Support, $42/hr, Remote, Evening, No Experience
Virtual Assistant, $50/hr, Weekend, No Degree, Remote
Remote Data Entry, $40/hr, Part-Time, College Student Job
Phone Support, Remote, $42/hr, Evening/Night Shift
Virtual Assistant, No Degree, $45/hr, Remote, Part-Time
Live Chat Support, $50/hr, Remote, No Experience Required
Remote Moderator, $42/hr, College Student, Weekend Job
Data Entry, $45/hr, Remote, Night Job, No Degree
Virtual Assistant, $50/hr, Remote, Part-Time, Evening Job
Remote Customer Support, $42/hr, Weekend, No Experience
Phone Job, $45/hr, Remote, Night Shift, No Degree
Remote Live Chat, $50/hr, College Student, No Experience
Data Entry, $40/hr, Part-Time, Remote, Weekend Job
Virtual Assistant, $42/hr, Remote, No Experience, Evening
Remote Phone Support, $45/hr, Night Job, College Student
Remote Moderator, $50/hr, No Degree, Weekend, Part-Time
Virtual Assistant, $40/hr, Remote, Night Shift, No Experience
Customer Support, $42/hr, Remote, Part-Time, No Degree
Remote Data Entry, $45/hr, Weekend Job, College Student
Phone Support, Remote, $50/hr, No Experience, Night Shift
Virtual Assistant, $42/hr, Evening, Remote, College Student
Live Chat Support, $45/hr, Part-Time, Remote, No Degree
Data Entry, $50/hr, Remote, Evening Job, College Student
Virtual Assistant, $40/hr, Weekend, Remote, No Experience
Remote Phone Job, $42/hr, Night Shift, College Student Friendly
Remote Customer Support, $45/hr, No Degree, Evening Job
Virtual Assistant, $50/hr, Part-Time, Remote, Weekend Job
Data Entry, $40/hr, Evening Job, No Experience, Remote
Remote Live Chat, $42/hr, Weekend, No Degree, Part-Time
Virtual Assistant, $45/hr, No Experience, Remote, Night Job
Phone Job, $50/hr, Remote, Part-Time, College Student
Remote Data Entry, $42/hr, Evening/Night Job, No Experience
Remote Moderator, $45/hr, No Degree, Weekend Job, Part-Time
Live Chat Support, $50/hr, Remote, Night Shift, No Degree
Virtual Assistant, $40/hr, Weekend, College Student, Remote
Remote Phone Job, $42/hr, Part-Time, No Experience Required
Remote Data Entry, $45/hr, No Degree, Weekend, Night Job
Virtual Assistant, $50/hr, Evening, Remote, College Student
Customer Support, $42/hr, Weekend Job, Remote, No Degree
Phone Support, $45/hr, Remote, No Experience, Evening Job
Remote Phone Job, $42/hr, Part-Time, College Student Friendly
Virtual Assistant, $40/hr, Remote, No Degree, Night Job
Part-Time Data Entry, $45/hr, Remote, College Student Friendly
Remote Moderator, No Degree, $50/hr, Evening, Weekend Job
Remote Customer Support, $42/hr, Night Job, No Experience
Live Chat Support, $40/hr, Remote, Entry Level, Part-Time
Virtual Assistant, Remote, $42/hr, Weekend, No Experience
Remote Data Entry, $45/hr, No Degree, Night Shift
Part-Time Customer Support, $40/hr, Remote, College Student
Qualifications
Minimum Education
- Bachelor's Degree Nursing, Social Work, Health Services (Required)
- Master’s Degree in Nursing, Social Work, Health Services (Preferred)
Minimum Work Experience
- 3 years of progressive supervisory experience preferred (Preferred)
- 3 years of related experience in managed care and /or care management (Preferred)
Required Skills/Knowledge
- Understanding of Medicare/Medicaid benefits
- Excellent verbal and written communication skills
- Familiarity with computer systems and applications.
- Computer literate in Microsoft suite
- Strong organizational skills
- Ability to interpret and apply departmental requirements
- Ability to make sound decisions and use good judgment
- Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service
- Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practice
Required Licenses And Certifications
- Registered Nurse Licensed in New York State Upon Hire (Required)
- Certification in Case Management (Preferred)
Job Functions/Essential Duties:
- Responsible for day-to-day operations of an assigned team
- Responsible for a team of licensed and unlicensed care management staff
- Reviews cases regularly with staff; acts as a clinical consultant regarding care management issues; guides clinical staff with review of assessments and care plans, evaluates utilization reviews and/or documentation
- Assists the Director of Care Management in establishing, implementing, and ensuring care management policies, practices, and procedures are in place
- In conjunction with the Director of Care Management, coordinates, develops and implements action plans to respond to areas of need
- Leads and offers expert guidance and direct supervision to the team in aspects of care management: assessment, planning and implementation, coordination
- Assist the team with monitoring, and evaluation of options and services to meet the routine and complex health and behavioral health care needs of members
- Monitors work performed by team members according to organization, department and community standards
- Monitors productivity using various reports to support appropriate outcomes and assign corrective action plans to staff as needed for immediate review and resolution
- Conducts regular team meetings in accordance with contractual agreement and as needed
- Responsible for completing all annual performance reviews for assigned staff
- Apply advanced problem-solving and analytical skills to evaluate and address complex situations involving members, providers, staff and community professionals
- Submits routine and special reports as assigned or requested.
- Participate in internal and external multidisciplinary team meetings.
- Attends/conducts meetings internally or externally with other government agencies or community organizations involved with enrollees in the health plan as needed
- Conducts weekly/bi-weekly supervision with assigned staff
- Responsible for oversight of assigned staff in maintaining caseload and contractual compliance metrics
- Clinical Supervisor of Care Management (Special Populations):
- The responsibilities of the Care Management staff assigned to these populations are inclusive of the duties outlined above with further detail in their respective program description and/or policy.
Other Job Duties:
- May perform other duties in addition to those outlined in this job description
- Organizational Accountabilities
Leadership Excellence
- Demonstrates understanding of quality of service and collaborates with co-workers to ensure excellence is achieved
- Innovates through improvement of care and/or efficiency of operational processes.
- Dedicated to a standard of performance excellence and high quality
Collaboration
- Creates a safe environment that encourages brainstorming, creativity and “out-of-the-box” thinking
- Encourages a diverse group of people to communicate effectively and embrace creative thinking
- Drives the collaborative efforts of the team to achieve goals in the most effective and efficient way
- Demonstrates listening and feedback skills
Leadership Skills
- Proactively assumes responsibility and accountability for results to include management of organizational change
- Empowers staff in ensuring a culture of transparency, fairness, respect and excellence
- Strategically aligns operational and tactical objectives to drive business results
- Encourages collaboration with team members based on trust, mutual respect, consistent visible support, and open and honest communication
- Supervisory Responsibilities
- The incumbent will be responsible for the general direction of staff members(s).
Protected Health Information Access Level
- Full Access Incumbents in this job may access any protected health information associated to a customer's needs, the service(s) rendered and the position's functions.
Working Environment
- This job operates in an office environment.
Physical Requirements
Sedentary Work: Lifting 10 lbs. maximum and occasionally lifting and/or carrying such articles as dockets, ledgers and small tools. Although a sedentary job is defined as one that involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required only occasionally, and other sedentary criteria are met.
Company Description
Doral Health & Wellness is a superior multi-specialty practice located in the Brownsville neighborhood of Brooklyn, New York City. The highly trained medical team offers top-quality interdisciplinary medical care and advanced services in a comfortable, welcoming environment.
Company Description
Doral Health & Wellness is a superior multi-specialty practice located in the Brownsville neighborhood of Brooklyn, New York City. The highly trained medical team offers top-quality interdisciplinary medical care and advanced services in a comfortable, welcoming environment.
