Nurse Practitioner Clinical Network Manager- Illinois

Company: Signify Health
Location: Elmhurst
Posted on: June 10, 2021

Job Description:

How will this role have an impact?

While there are many goals of the Complex Care Management program, the overarching goal is to improve the quality of life for our members by reducing overall utilization and preventing unnecessary hospitalizations and emergency rooms visits. Signify Health is focused on improving the quality of life for health plan members through effective care coordination and best in class care management. Our Complex Care Management program services our clients’ dual eligible members residing in long term care facilities. The Complex Care Management Clinical Network Manager role functions within a multidisciplinary team to positively impact member healthcare outcomes. 

This role will report to our Senior Clinical Network Manager, Care Coordination

What will you do?

• Must reside in the state of Illinois.
• Direct supervision/management of clinical pod teams (NPs and RNs) supporting Signify Health’s CCM program including performance oversight, coaching, evaluating, and disciplinary actions, as indicated
• Evaluate clinical staff clinical practice and relationship management skills, providing supportive performance coaching through regular cadence of comprehensive member reviews and periodic field visits (NP ride-alongs)
• Frequent on-site visits to various environments including but not limited to member living facilities (SNF and SLF), individual CCM metros, client sites, and Signify Health corporate offices 
• Monitor clinical staff performance through KPIs/ performance metrics scorecard, provide 1:1 feedback, and hold clinicians accountable for productivity and clinical quality of performance
• Promote top of license practice for NP staff with focus on timely “treat in place” quality care, accuracy of risk adjustment coding, capture of HEDIS gaps, and collaborative care with members, their family, PCP, and other members of the caregiver team
• Evaluate/track hospital admission reviews and follow high risk cases throughout the treatment continuum, providing clinical coaching to improve clinical outcomes, engaging Medical Director and Senior Manager, Clinical Network, Care Coordination as needed  
• Monitor NP skilling practices, ensuring that skilling is appropriately ordered and supported by clinical documentation and provide guidance for NPs as needed on Peer- Review process for denials
• Facilitate regular meeting cadence between Signify Health clinical staff  and health plan Case Managers;  Ensure that clinical staff are appropriately prepared for internal and health plan ICT meetings with “client ready” materials and attend all of these meetings as scheduled
• Assist Senior Manager, Clinical Network, Care Coordination in monitoring individual clinical staff caseloads and make recommendations as needed for adjustment and assignment of new membership
• Develop effective working relationships between internal clinical pod members, CCM operations team, providers, and clients as applicable  
• Support clinical pod teams in continuous quality improvement initiatives to ensure ongoing effectiveness and compliance of complex care management program 
• Collaborate with CCM Clinical Educator on identification of new hire and ongoing learning needs, as well as design and delivery of learning content.
• Support recruitment and retention opportunities for Signify Health’s CCM program including, but not limited to, interviewing and hiring decisions
• Provide general management support to CCM clinical staff including review and approval of scheduling requests, expense report approval, etc.
• Plan and lead routine staff meetings, individual pod meetings, conferences, and ancillary training
• Provide back- up management support for other Clinical Network Managers as needed
• Complete reports/projects/tasks as requested by Senior Manager, Clinical Network, Care Coordination, Medical Director, and other members of the CCM leadership team
• Promote Signify Health Core Values of Accountable, Inclusive, Compassion & Adaptive
• Daily troubleshooting of program/processes as indicated

We are looking for someone with:

• Active, APRN license in the state of Illinois with no restrictions; Willingness to obtain additional state licenses upon request
• Current ANCC or AANP Board Certification in Family, Adult or Geriatric Medicine
• Previous Clinical Management experience required; Complex Care Management experience preferred
• 2 years Case Management, Utilization Management, or Transitional Care experience preferred
• Minimum of 2 years’ clinical experience working with complex adult populations preferred
• Strong knowledge of various chronic medical conditions along with the associated routine lab monitoring, diagnostic, and treatment options as well as commonly prescribed medications for those conditions
• Ability to work in fast-paced environment and adapt well to frequent change
• Strong organizational skills and the ability to prioritize competing work responsibilities
• Ability to travel up to 50% of the time (air/land travel), may include some overnights and weekends

About Us: 

Signify Health is helping build the healthcare system we all want to experience by transforming the home into the healthcare hub. We coordinate care holistically across individuals’ clinical, social, and behavioral needs so they can enjoy more healthy days at home. By building strong connections to primary care providers and community resources, we’re able to close critical care and social gaps, as well as manage risk for individuals who need help the most. This leads to better outcomes and a better experience for everyone involved.  

Our high-performance networks are powered by more than 9,000 mobile doctors and nurses covering every county in the U.S., 3,500 healthcare providers and facilities in value-based arrangements, and hundreds of community-based organizations. Signify’s intelligent technology and decision-support services enable these resources to radically simplify care coordination for more than 1.5 million individuals each year while helping payers and providers more effectively implement value-based care programs. 

To learn more about how we’re driving outcomes and making healthcare work better, please visit us at www.signifyhealth.com.

Keywords: Signify Health, Elmhurst , Nurse Practitioner Clinical Network Manager- Illinois, Other , Elmhurst, Illinois