Manager FV Partners Care Coordinator - RN

Job OverviewFairview Partners (FVP) provides high intensity care coordination and case management for seniors and other at-risk populations living in a variety of care settings in the 11-county metro area. The RN Care Coordination Manager assists the Director of Care Management in the day-to-day management of department care coordination staff and performs other administrative duties to support clinical operations, as assigned by the Director. The RN Care Coordination Manager assures that care is delivered according to department policy and models best practice in these case management functions: assessment, care planning, service coordination and referral, transition management, utilization management and quality assurance. Care coordination for the FVP population is delivered via partnerships with managed care organizations (MCO) and must adhere to regulations set forth by the MCOs, the Minnesota Department of Human Services (DHS), the Minnesota Department of Health (MDH) and the Centers for Medicare and Medicaid Services (CMS).This Manager RN care coordinator schedule includes;80 hours ever two weeksFull time; Day shiftNo weekendsResponsibilitiesActs as the Manager for a Fairview Partners geographical area and/or clinical team:Supervises a team of care coordinators, acting as immediate contact for staff questions and concernsConducts annual performance reviews with staffFacilitates training opportunities for staff in coordination with department and system education resourcesActively encourages employee development and meets regularly with staff members on a one-on-one basisApproves employee time cards and manages absenteeism according to system and department policyEnforces all other department and system personnel policiesActs as the hiring manager for approved positions in assigned area in consultation with the directorIs present during interviewing process for potential employees outside assigned area, at the request of the directorServes as contact point for member complaints and grievances and has authority to reassign cases when necessaryFollows Fairview’s policy for corrective or disciplinary actionRotates monthly case assignment with other managers and/or directorAssures that care coordinators work at the top of their licensureUnderstands nursing scope of practice as it applies to the FVP RN Care Coordinator role and provides professional guidance to staff as neededRepresents Fairview Partners on system committees or workgroups, as requested by directorCovers duties in absence of other managers or director’s absenceProvides Care Coordination/Case Management to the FVP population:Manages a panel of members in accordance with duties set forth in the FVP RN Care Coordinator job descriptionModels best practice in all areas of care coordination/case managementGives clinical direction in accordance with CMS, DHS and health plan regulationsProvides guidance to Case Management Specialist role as it pertains to member communication, service referral authorization and appropriate delegation of care management tasksMaintains department clinical operationsMaintains knowledge of current DHS policy concerning Long-Term Services and Supports, Medical Assistance benefit coverage and Elderly Waiver eligibility and benefitsMaintains knowledge of Medicare benefits and policy as it applies to health plan contracted servicesMaintains knowledge of FVP clinical policies and network operationsEssential FunctionsPromotes the Fairview system care continuum and maintains professional relationships with system care partnersCoordinates with director to ensure updates from CMS, DHS, MDH and contracted health plans are distributed and understood by care coordination staff membersServes as point of contact for health plan communication; responds to health plan inquiries in a timely mannerAttends all health plan care coordinator meetingsAttends DHS and other training events at the request of the director Provides input to director for annual budgeting forecastsLeads staff meetings and huddles, as directed by managementActively supports quality and process improvements to achieve superior clinical outcomes and financial performance for FVP:Participates in department quality and utilization meetings Attends interdisciplinary team conferences and provides clinical guidance to care coordination team regarding high-risk and medically complex casesRegularly reviews high-risk cases with team members to facilitate optimal clinical outcomes Provides input on and leads clinical performance improvement projects Supports efforts to maintain data integrity by enforcing department documentation and quality reporting standards Assists with annual health plan audit preparation, as needed, and attends health plan audit reviewsRequired QualificationsAssociate of Arts Associate Degree with five years nursing experience5 years coordination/case management, public health, geriatric nursing or managed care experienceClinical experience in a hospital and/or clinic setting, managing clinical professionalsExperience working with interdisciplinary clinical leadership teams on collaborative effortsSupervisory/management experienceStrong knowledge of managed care programs, long-term services and supports, Medicare and Medicaid benefits and senior care industryExcellent computing skills including keyboarding, Microsoft Word, Outlook and Excel and Adobe Acrobat; demonstrated proficiency with electronic medical record systems; excellent written and verbal communication skillsRegistered NursePreferred QualificationsBachelors Degree in NursingSeven to ten years of experience in care coordination/case management, public health, geriatric nursing or managed careMinnesota Public Health Nurse license, Certification in Case Management or Geriatric NursingDrivers LicenseBasic Life Support (American Heart Assoc or Red Cross)American Red Cross: CPR/AED for Professional Rescuers and/or Healthcare Providers, Life Guarding First Aid/CPR/AEDBLS InstructorBenefit OverviewFairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link foradditional information: https://www.fairview.org/careers/benefits/noncontractCompensation DisclaimerThe posted pay range is for a 40-hour workweek (1.0 FTE). The actual rate of pay offered within thisrange may depend on several factors, such as FTE, skills, knowledge, relevant education, experience,and market conditions. Additionally, our organization values pay equity and considers the internal equity of our team when making any offer. Hiring at the maximum of the range is not typical. If yourrole is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored.EEO StatementEEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status