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Texas Health Resources Manager Complex Care Management-SWHR CIN in Dallas, Texas

Southwestern Health Resources Clinically Integrated Network (SWHR CIN), is hiring for a Manager Complex Care Management

Nurse managers provide the vital link between the administrative strategic plan and the point of care. The nurse manager is responsible for creating safe, healthy environments that support the work of the health care team and contribute to patient engagement. The role is influential in creating a professional environment and fostering a culture where interdisciplinary team members can contribute to optimal patient outcomes and grow professionally.

This position collaborates with the Director of Care Management to provide adequate staffing levels, appropriate learning experiences, professional work environment utilizing a team approach, and ongoing communication with the multidisciplinary team to ensure that SWHR provides high quality patient care in a cost-effective manner. The Nurse Manager's responsibilities include hiring, terminations, performance management, disciplines, orientation, and conducting staff meetings.

Location: Farmers Branch

Core Hours

• Full time, Monday through Friday, 8am-5pm

Job Description

Supports and guides care management functions in a fast paced, growth-oriented population health organization. Responsible for the development and execution of care management activities (including transition of care) to drive compliance with health plan partners’ models of care and contractual requirements.

Monitors care management clinical operations as well as contractual and regulatory operational requirements to drive compliance, quality outcomes and operational efficiencies. Responsible to support achievement of cost, quality, utilization, and patient/member experience goals.

Identifies and executes on best practices for member assessment, care plan development (as applicable), care management/care coordination, transitions of care and end of life care. Monitor performance quality and performance metrics while also providing recommendations on operational design and efficiencies

Effectively manages day-to-day functions to maximize time and achieve goals. Leads the care management team by ensuring they are effectively and efficiently operated, resourced, and performance managed accordingly. Monitors staffing, caseload, productivity, and budget for care management.

Participates in personnel management including recruiting, hiring, goal setting, evaluations, and team building. Supports initial and ongoing training development and facilitation for new and existing staff. Develops care management policies, procedures, and/or other job aides as needed. Develops performance improvement plans or other quality monitoring tools to support performance expectations for all staff.

The ideal candidate will possess the following qualifications

Education

Bachelor's Degree Nursing, or healthcare related field required

Master's Degree Nursing, Social Work, Psychology, Health Administration, Public Health or other relevant Master's degree preferred

Experience

5 years ACO, Health Plan or Provider care management experience required to include 3 years previous experience in a manager or supervisor role required.

2 years experience with Medicare Advantage, Bundled Payments, Direct Contracting and/or CSNP/DSNP programs preferred.

Licenses and Certifications

RN - Registered Nurse-Active RN License required upon hire

CCM - Certified Case Manager preferred upon hire

Skills

Data analytic skills required. Able to review data and make recommendations and formulate action plans in response to data findings

Strong professional organizational, interpersonal skills and critical-thinking skills required for effective and creative leadership.

Strong communication, customer service and decision making skills; standards of care, and regulatory standards required.

Proven leadership experience that includes team building, motivating staff with enthusiasm and compassion, communicating skills across disciplines

Possess good analytical and problem-solving skills.

Proven success in teambuilding and training / coaching staff to meet operational requirements and goals. Ability to work with computerized clinical information systems.

Southwestern Health Resources (SWHR) is a patient-centered clinically integrated network of 29 hospital locations and more than 5,500 physicians and other clinicians. Formed by Texas Health and UT Southwestern, two of the region’s leading healthcare systems, SWHR delivers nationally preeminent, highest-quality care in 16 counties across North Texas. SWHR is also the parent organization of Care N’ Care Insurance Co., a regional Medicare Advantage Plan serving more than 13,500 members in the region.

The SWHR network includes physicians from UT Southwestern and Texas Health, and independent community primary care and specialty physicians. In partnership, our team implements physician-driven, value-based care strategies to coordinate care for more than 700,000 patients, resulting in lower costs and high-quality care. In 2020, the Centers for Medicare & Medicaid Services released the annual financial and quality results and, based on the report, SWHR is one of the nation’s leading Next Generation Accountable Care Organizations, having saved nearly $120 million since joining the program in 2017.

At the heart of SWHR are people who help people. We care about those we serve and each other. To be the national leader in providing population-based healthcare, our more than 850 employees use their knowledge, data insights and clinical experience to deliver care to the right patient, at the right time and in the right setting. By connecting physicians to patients and clinical insights to better outcomes, SWHR lowers costs, optimizes value, and builds a better healthcare system for all.

We invite you to learn more about us at www.southwesternhealth.org.

Let’s move healthcare forward – together.

Employment opportunities are only reflective of wholly owned Texas Health Resources entities.

We are an Equal Opportunity Employer and do not discriminate against any employees or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

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