High Risk Nurse Supervisor

Summary: The High-Risk Nurse Supervisor is responsible for the clinical support staff as well as co-management with the department Manager and Team Lead. The High-Risk Nurse Supervisor also tracks Case Management High Risk metrics, conducts staff training, and audits. Ensures timely care plans are developed and implemented to optimize patient outcomes and utilization management. Works closely with Case Management, Case manager assistants, Clinical teams, providers, and other GMG staff to achieve organizational goals, and efficient and effective team processes to serve patients and providers.

Responsibilities

• Directs day-to-day departmental activities including scheduling, staffing and oversight of daily operations. Coordinates work schedules, coverage plans and assignments for Case Management/High Risk Team (CM/HR).
• Monitors the status of work, via reports, flags, phone calls, and other means. Facilitates the process to ensure timely service to patients and providers.
• Reviews and monitors the work performed and documentation in Electronic Medical Record (EMR) to evaluate knowledge, skills, quality of care and appropriateness of documentation.
• Ensures that Census, Radar Report, Bed Days report and High-Risk Patient Status are completed accurately and distributed in a timely manner.
• Ensures that CM/HR team supports effective Patient Care Committee, High Risk and Small Group Meetings.
• Identifies opportunities for operational improvement and works collaboratively with the CM/HR team and other GMG staff. Communicates effectively with clinic staff, internal providers, patients, and external providers regarding CM/HR matters.
• Continually Audits processes to identify opportunities for improved consistency and improved quality outcomes.
• Participates in defining annual departmental goals/objectives and takes responsibility for their achievement. Effectively engages CM/HR staff in accomplishment of goals.
• Helps to develop, review, and maintain departmental policies and procedures. Participates in the development of organizational policies and procedures.
• Ensures staff members follow departmental and organizational policies and procedures, including CM/HR processes and compliance with GMGs mission, vision, values, and behavioral expectations.
• Provides clear directions, consistent and timely feedback to CM/HR staff. Promotes teamwork in daily activities.
• Assists with hiring, training, on-going supervision, discipline, and evaluation of staff. Helps provide a comprehensive orientation and staff development program. Provides timely feedback and staff evaluations.
• Supports GMG goals by actively participating in Orientation, Training Programs, Task forces, project Teams and other special endeavors.
• Ensures that CM/HR staff maintains strictest member and company confidentiality; ensures member health information is secured each day; Demonstrates HIPAA knowledge and focus.
• Able to work efficiently under pressure.
• Performs other duties as assigned.