The RN Clinical Team Manager/MLTC responsible for the day-to-day operation and performance of MLTC program Care Management department within the compliance with CCS business products policies, procedures and all regulatory mandates, consistent with health plan mission, vision, purpose and value statements.
· The Registered Nurse Clinical Team Manager manages clinical staff (Supervisors, RN Care Managers, and Social Workers) and non-clinical Care Coordinators staff (that supports clinical functioning) and associated activities in compliance with State and Federal regulatory requirements CCS policies and procedures.
· The Registered Nurse Clinical Team Manager assigns member case to RN Care Managers based on geographical area and member cultural and linguistic preferences. Monitors individual case loads.
· The Registered Nurse Clinical Team Manager continually monitors timeliness and appropriateness of documentation including but not limited to comprehensive assessments, person-centered service plan, care plan, in care management data system and where appropriate (i.e. HCS-UASNY) to ensure that documentation meets State and Federal regulatory standards and CCS policies and procedures.
· The RN Clinical Team Manager continually monitors timeliness and appropriateness of Interdisciplinary Team Meetings (IDT) in compliance with the State and Federal requirements and CCS policies and procedures.
· The RN Clinical Team Manager monitors employees’ performance, key performance indicators, audits, case reviews, etc. Performs corrective action and/or counseling as needed.
· The RN Clinical Team Manager trains employees in process operations and acts as a preceptor to newly hired staff.
· The RN Clinical Team Manager completes staff evaluations as needed and other duties as assigned.
· Knowledge of current community health practices for the frail adult population, behavioral health and cognitively impaired seniors and disabled including knowledge of physical health, aging and loss, appropriate support services in the community, frequently used medications and their potential negative side-effects, depression, challenging behaviors, Alzheimer’s disease and other disease related dementias.
· Understanding of and sensitivity to members cognitive ability, means of communication and cultural differences and needs of the community are essential.
· Knowledge in management and oversight of personnel.
· Graduate of a 2- 4 year accredited nursing program;
· Active and unrestricted NYS RN license
· Minimum 5-8 years clinical experience
· Excellent written and verbal communication skills.
· Proficiency in the use of Microsoft Office tools
· Strong problem-solving ability
· Managerial experience
· Bachelor of Science in Nursing or Advanced Degree
· CCM certification
· Knowledge of UAS-NY assessment
· Hours 9:00am-5:00pm
· Paid Training
· Commuter Account
· 401k with Company Contribution
· Generous Paid Time Off and Paid Holidays
· Referral Bonuses!!
Who We Are: Centers Care Solutions (CCS), is a Managed Care Organization servicing members with Medicare and/or Medicaid. Our goal is to provide members and all those involved in their care with the guidance and health plan choices they need for healthy living. CCS is committed to providing quality, coordinated health care to some of the most honored and yet still vulnerable members of our community