Clinical Manager Care Management Org

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Job Summary
The Clinical Manager has responsibility for the day to day operations of the multidisciplinary teams created to implement organizational  programs.  The Clinical Manager supervises nursing, social work, administrative and other professional staff.  The Manager ensures that appropriate actions are taken consistent with developed policies and procedures and using available automated systems (e.g. EPIC, CIS, tele-monitoring devices, etc.).  The Clinical Manager assists in development of policies, procedures and work flows; monitors work flow and staff effectiveness; assures that appropriate interventions are offered to enrolled beneficiaries & members; assists in program monitoring; and identifies and assists in resolving barriers to successful implementation of the Care Management/ Utilization Management Programs. Position supports staff development and training. 

Qualifications

• Bachelor degree in nursing or a health-related field required, Masters degree preferred.

• Current active license/registration in New York State as applicable and additional state licenses/registration (NJ, CT, etc.) as required by Program. 
• Medical Management experience in a managed health care setting preferred. 
• 5 years of clinical practice, preferably including at least 2 years in an outpatient setting .
• Minimum 2 years of supervisory experience. 
• Professional certification in Case Management, Utilization Management, or Quality Management preferred. 

• Knowledge of: 
 - Medicare & Medicaid benefits and guidelines 
 - case management concepts
- quality improvement techniques