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:

1. 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).
2. Monitors the status of work, via reports, flags, phone calls, and other means. Facilitates the process to ensure timely service to patients and providers.
3. Reviews and monitors the work performed and documentation in Electronic Medical Record (EMR) to evaluate knowledge, skills, quality of care and appropriateness of documentation.
4. Ensures that Census, Radar Report, Bed Days report and High-Risk Patient Status are completed accurately and distributed in a timely manner.
5. Ensures that CM/HR team supports effective Patient Care Committee, High Risk and Small Group Meetings.
6. 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.
7. Continually Audits processes to identify opportunities for improved consistency and improved quality outcomes.
8. Participates in defining annual departmental goals/objectives and takes responsibility for their achievement. Effectively engages CM/HR staff in accomplishment of goals.
9. Helps to develop, review, and maintain departmental policies and procedures. Participates in the development of organizational policies and procedures.
10. Ensures staff members follow departmental and organizational policies and procedures, including CM/HR processes and compliance with GMGs mission, vision, values, and behavioral expectations.
11. Provides clear directions, consistent and timely feedback to CM/HR staff. Promotes teamwork in daily activities.
12. 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.
13. Supports GMG goals by actively participating in Orientation, Training Programs, Task forces, project Teams and other special endeavors.
14. Ensures that CM/HR staff maintains strictest member and company confidentiality; ensures member health information is secured each day; Demonstrates HIPAA knowledge and focus.
15. Able to work efficiently under pressure.
16. Performs other duties as assigned.

Education and Experience: Graduation from an approved LVN or RN program. Must be state-licensed LVN or RN with a minimum of three years of LVN or RN experience, clinic experience preferred. Must have prior medical terminology. Must have excellent customer service skills. supervisory experience. Prior managed care experience preferred.

Computer Skills: Knowledge of Word Processing software, database software, spreadsheet, and internet software Supervisory Responsibilities: Directly supervises front line employees. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Work Environment: Depending upon the area assigned, may be 100% clinical setting or office setting in a clinical environment. Field work may be required for supervisory visits and or patient admissions to skilled services. Exposure to communicable diseases, bodily fluids, toxic substances, ionizing radiation, medicinal preparations, and other conditions common to a clinic environment.

Physical Demands: Requires manual dexterity, sitting, standing, stooping, reaching, kneeling, crouching, bending, walking, lifting up to 40 lbs. Close vision and ability to adjust focus.

The above job description Is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor. Reasonable accommodations may be made to enable otherwise qualified individuals with disabilities to perform the essential functions of the job.