DescriptionPOSITION SUMMARY: Responsible for day to day supervision of care coordination and population health programs. In conjunction with director will oversee planning, budget, and implementation of care coordination programs both internal and external. Provides leadership to care coordination staff in areas such as; job duties, productivity, attendance, customer service.
Responsible for advancing the functionality and reporting efficiency of a variety of Alternative Payment programs including but not limited to the following: CHQCA and community provider practices including training on HEDIS measures and annual quality abstraction to support (Medicare Shared Savings Program).
This position is responsible for the oversight of the Mayo Clinic E-consult, E-boards data support. Enhanced Oncology Care Model CMS, Transition of Care Programs, PCMH, VBP via cloud based data applications. Manager is responsible for compilation and preparation of data results related to all aspects of care coordination operations including; ACO care gap closures, CMS data metrics and documentation that supports contracted alternative payment models including; CHRISTUS Health Plan, BCBS, Presbyterian Centennial, Optum, United Health Care STARS program and others. Manager provides supervision of accurate and timely billing for non-face to face services for CMS program work.
RequirementsMINIMUM QUALIFICATIONS:
EDUCATION: Bachelors of Science in Nursing required.
CERTIFICATION/LICENSES: Current license to practice as a RN in New Mexico
SKILLS:
- Demonstrated knowledge of computer database function and reporting
- Must be able to read, write and speak English fluently
- Proficient in office management and administrative procedures
- Ability to develop and maintain strong working relationships with insurance providers, providers and leadership
- Relies on experience and judgment to plan and accomplish goals, lead and direct the work of others, and perform a wide variety of tasks
- A wide degree of creativity, latitude and autonomy is expected
- Advanced knowledge of computer technology, including word processing, spreadsheet, database, and graphics software in order to prepare publications, reports, and business correspondence
EXPERIENCE: Minimally five years supervisory experience in diversified positions within a health care organization. Considerable knowledge of population health and alternative payment models preferred.
NATURE OF SUPERVISION:
-Responsible to: Executive Director of Ambulatory Nursing
- Supervision of all care coordination staff
- Supervision of Value Based Purchasing and Alternative Payment Models and quality deliverables working in conjunction with Medical Director of Ambulatory Quality.
- Supervision and support of Mayo Clinic Care Network as it relates to the role of RN E-health coordinators.
- Supervision of Patient Care Coordinators who facilitate transition of care from inpatient and ED.
- Supervision of staff performing Pre-Surgical Assessment and Screening (PASS)
ENVIRONMENT:
- Bloodborne pathogen: A – Works in a clean, well-lighted, smoke free environment.
- Bloodborne pathogen: B – If involved in clinical contact.
PHYSICAL REQUIREMENTS: Subject to stressful professional relationships. Working hours vary, with flexibility due to unexpected changes in schedule and emergencies. Requires the ability to speak, listen, develop and communicate written materials. May be required to lift, push, pull and/or carry up to 50 lbs.
