Job Description :
This job is responsible for monitoring clinical operations, quality, key performance indicators and outcomes of the Enhanced Community Care Management (ECCM) field-based team. The incumbent is accountable to drive continuous quality improvement and implement process improvement initiatives in the work of POD-based teams of APPs, RNs, LSWs and care coordinators deployed to service patients in specific geographic regions.
- Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
- Monitor POD based staff, including (but not limited to) APPs, RNs, social workers and care coordinators, for Clinical Operations, assigning tasks and objectives, and establishing clear goals in order to measure results versus objectives.
- Responsible for the development and engagement of POD team by fostering and activating a motivating work environment that recognizes and rewards strong performance and Our Core Behaviors.
- Serves as a liaison between interdepartmental teams, referral sources and patients and families.
- Selects and maintains a qualified, well-organized staff to provide care for the needs of the patients. Promotes staff development and succession planning.
- Establishes staffing patterns, which reflect the quality and quantity of various personnel necessary to plan, provide, and supervise the care rendered to patients and families.
- Consults with the Director of Care Management, medical director and/or other treating physicians in matters relating to patient care services in order to ensure optimal person-centered care.
- Accountable for quality compliance and outcomes of the care provided by the POD team. Provides leadership in promoting and maintaining standards for providing excellent quality care by all members of the patient care team.
- Reviews patient and provider satisfaction data and findings and assists managers to formulate improvement plans.
- Other duties as assigned or requested.
- Bachelor's Degree in Nursing
- Master's Degree in Nursing
- 7 years in Case/Care Management
- 5 years in Leadership/Management
- 3 years of Palliative Care or Hospice Care
LICENSES or CERTIFICATIONS
- RN license in PA. Additional states will be required dependent upon work location.
- Problem Solving
- Motivational interviewing competency
- Advance care planning competency
- Ability to work in a high performing team environment that requires flexibility
- Excellent organizational and time management skills.
- Competent computer skills including Microsoft Office products
Language (Other than English):
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Teaches / trains others regularly
Travel regularly from the office to various work sites or from site-to-site
Works primarily out-of-the office selling products/services (sales employees)
Physical work site required
Lifting: up to 10 pounds
Lifting: 10 to 25 pounds
Lifting: 25 to 50 pounds
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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