MLTC Care Manager Supervisor - Nascentia Health

Provides oversight of care management through a collaborative process of assessment, planning, facilitation, and advocacy to meet members' health needs. Also, provides oversight for the provision and coordination of quality care and services for the Syracuse South team.

Job Requirements:

The Care Manager Supervisor supervises care management practice within the team concept to ensure a high quality of professional service and maintenance of Nascentia Health Options’ standards and policies.

1. Provides direct oversight of the care manager’s daily operations of utilization review practice, process and procedures ensuring accurate member care needs are met and documented per the managed long term care program (MLTC) regulations.
2. Completes Quality/Utilization chart reviews per agency policy.
3. Completes member care conferencing with care manager per agency standard.
4. Provides oversight to care management team ensuring that the case management process is being facilitated and services provided to meet member’s health needs.
5. Ensures care management staff have completed all assessments, reassessments, and member contacts within regulatory time frames.
6. Utilizes care standards and strategies when reviewing care plans.
7. Collaborate with care managers on strategies to implement, revise and amend service plans as needed based on changes to member’s physical, mental, and social wellbeing.
8. Promotes quality cost-effective outcomes.
9. Acts as liaison and advocate for members and Nascentia staff.
10. Monitors care management activities, services, and member’s response to interventions to determine effectiveness of plan of care and the utilization.
11. Assist in identifying trends and needs of the community and develop interventions based on identified needs.
12. Ensures compliance with all State and Federal regulations, and requirements.
13. Participates in Quality Assurance and Improvement activities.
14. Coordinates and assigns new members to the care management team.
15. Oversight of member’s hospital and skilled nursing facility admissions/utilization.
16. Routinely communicates changes/updates to staff, other departments, and Regional Director of Care Management as necessary

Requirements:

1. Strong communication skills (written and oral).
2. An understanding of Medicare/Medicaid regulatory and entitlements.
3. Knowledge of chronic disease management.
4. Demonstrated ability to work with a multidiscipline team.
5. Strong clinical skills and critical thinking skills
6. Bilingual skills preferred.
7. Ability to work independently, multiple assignments, prioritize workload.
8. Strong communication skills person to person and by phone

Qualifications:

1. Nursing: License and current registration as a Registered Professional Nurse in New York State. Education: BSN preferred; Associates Degree required
2. Valid New York State driver’s license.
3. Minimum of five-year RN experience in home care, long term care setting, or managed care experience required. Clinical expertise in chronic disease management preferred. Previous supervisory experience preferred.
4. Long Term Care and or managed care experience preferred.
5. Knowledge of homecare, Medicare and Medicaid preferred
6. Case Management Certification Preferred

Physical Requirements:

1. Standing, sitting, bending, walking, and driving (frequently entering and exiting vehicle throughout the day) are standard postures.
2. Frequently uses a laptop computer to enter orders and obtain product information.
3. Sensory requirements include speech, vision, smell, and hearing.
4. Lifting requirements of up to 20 pounds frequently and up to 50 pounds occasionally
5. Bloodborne Pathogens Exposure Category I - Employee has tasks that routinely involve exposure or potential exposure to blood, body fluids or tissues.

Compensation & Benefits:

Competitive Salary [This position is an S05 exempt position with a min-max rate of: $84,195-$97,680/annually] with:

• 401K with generous Employer match
• Medical, Dental, Vision plans
• Tuition Reimbursement for BSN after 6 months of employment
• Exceptional work/life balance - no rotating shifts
• Partially funded HSA
• Employee Recognition Platform
• Paid Time Off, Holidays, and Extended Sick Leave
• Short/Long term Disability
• Employee Assistance Program (EAP)
• Much More!!

______________________________________________________________________________________

About Nascentia Health:

Nascentia Health is leading the way in home care, post acute care and long-term community health. A healthcare system without walls, Nascentia is an innovator in the concept of healthcare, truly focused on the patient as a whole. By serving people in their homes, Nascentia Health is able to provide true holistic care. We can address immediate needs, help support positive long term medical and lifestyle choices that provide for better outcomes, leverage cutting edge in-home care technologies, and help avoid unnecessary visits to busy healthcare facilities.

Our employees are our greatest asset. They work hard every day to make our system amazing and are dedicated to our mission of being the premier home and community-based care system for the regions we serve. We want everyone to love what they do, be excited about coming to work, and take pride in being part of our team.

________________________________________________

Nascentia Health is an Equal Opportunity Employer (EOE)

Employment is contingent upon negative results of a pre-hire drug screen