The Supervisor, Population Health & Case Management supervises and supports the Director of Population Health & the Director of Medical Management in their vision for the Population Health & Case Management Departments, including planning, organizing, and coordinating the activities of the Population Health & Case Management programs. Requirements include working knowledge of Population Health, Accountable Care Organizations, Clinical Integrated Networks, EMRs, Value-based Contracts, CMS guidelines, Quality Measures including definition, interpretation, and documentation of inclusions and exclusions, Transitions of Care, Post-Acute Home Health Recertification, MCG Chronic Care Guidelines and Home Care Guidelines, Clinical Workflow in Primary Care Setting with ability to work with Primary Care Clinics to implement Care Coordination/Nurse Navigation without interruption of workflow or impacting clinician/staff satisfaction.
Supports leadership with the selection, training, development, appraisal, work assignments, staffing and productivity of Associates within Population Health & Case Management
Understands and supports "Triple Aim" objectives of Population Health and promotes these objectives in concert with organizational Core Values when supervising and leading the teams.
Provides formal, structured orientation/training process for new Associates with regular opportunity for feedback and assessment of competency upon completion
Collaborates with Primary Care Clinics to implement Care Coordination/Nurse Navigation for value-based contracts; has experience with ambulatory clinic workflow with the ability to partner and troubleshoot with the ambulatory clinical team to develop and refine operational workflows within the practice and specific EHR; familiar with order sets, appointment templates, scheduling of procedures, and pre-authorization
Capable of learning to navigate EHRs to thoroughly research the patient medical record to locate and identify documentation for completion of quality measures; have or can learn to have expert clinical knowledge of quality measures with ability to interpret definitions regarding inclusions and exclusions
Collaborates with Primary Care Clinical Team to develop and test operational workflows within specific EHR to communicate/document appropriate Home Health Case Conference information and recertification recommendations to the clinician
Ability to develop collaborative relationships with Home Health Agencies to coordinate 485 plan of care process and Case Conference scheduling
Collaborates with Primary Care Clinics to implement Transitions of Care Program with expertise and understanding the CMS requirements for timely outreach, and necessary components of telephonic encounter/documentation for prevention of readmissions and billing higher revenue TOC codes
Develops expertise in Wellcentive Outcomes Manager/PO Administration application
(Super User) or other Care Management documentation platform utilized by depai_ talent
with the ability to provide appropriate monthly reporting and dashboards for leadership
Has working knowledge and expertise of all associate roles in the department and is capable of stepping in to assist as needed
Supervises daily activities of Population Health & Case Management clinical staff, individually and as a team to ensure the following objectives are met:
Maintains appropriate staffing ratios and team assignments based on volumes
Responsible for development and maintenance of policies and procedures for the department .
Responsible for HIPAA and Integrity compliance within department
Works closely with department Directors to identify and plan for opportunities for improvement within areas of responsibility
Graduate of an accredited Registered Nursing program
Bachelor Degree In Nursing, Preferred
Excellent computer skills needed
Experience with word processing/spreadsheets including Excel.
Excellent verbal and written skills
Minimum of five years of clinical experience
Three years of Case Management experience preferred
Current/Active unencumbered Texas RN licensure
Eligibility for Louisiana RN licensure (obtained within 6 months of employment)
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.