What are the responsibilities and job description for the Manager, Clinical Care position at Guidehealth?
Company Description
WHO IS GUIDEHEALTH?
Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealthleverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealthempowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.
Join us as we put healthcare on a better path!!
Job Description
The Value Based Clinical Care Team Manager is primarily responsible for the day-to-day operations of an integrated multi-disciplinary clinical and clinical support structure that will effectively monitor, support, and lead Value Based clinical initiatives. This includes but is not limited to case management, transitions of care, care coordination and continuity, provider/staff education on ACO/MA Plan clinical programs, and helping to build and maintain a network of community support. This individual must exhibit strong leadership, management, and interpersonal skills, as well as the ability to utilize both internal and external resources to accomplish the goals and objectives of the organization.
What You’ll Be Doing
What You’ll Need To Have
The salary for this role is $95,000.00 per year.
BENEFITS:
All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:
The listed compensation range listed is paid bi-weekly per our standard payroll practices.Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT
Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.
Our Comittment To Protection Of Patient And Company Data
This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.
Remote Work Technical Requirements
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The recommended internet speed is a minimum of 50 mbps download, 10 mbps upload. Please consult with your internet provider or run a speed test hereto confirm your internet connection meets these requirements.
WHO IS GUIDEHEALTH?
Guidehealthis a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealthleverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealthempowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.
Join us as we put healthcare on a better path!!
Job Description
The Value Based Clinical Care Team Manager is primarily responsible for the day-to-day operations of an integrated multi-disciplinary clinical and clinical support structure that will effectively monitor, support, and lead Value Based clinical initiatives. This includes but is not limited to case management, transitions of care, care coordination and continuity, provider/staff education on ACO/MA Plan clinical programs, and helping to build and maintain a network of community support. This individual must exhibit strong leadership, management, and interpersonal skills, as well as the ability to utilize both internal and external resources to accomplish the goals and objectives of the organization.
What You’ll Be Doing
- Effectively managingday to day Health Plan Clinical Programs to enhance clinical efficiencies
- Identifying opportunities for increased outpatient vs. inpatient utilization
- Utilizingdata provided to help in managing population health needs and implement population programs for Health Plan beneficiaries
- Executingcase management for patients identified at highest risk for adverse event or exacerbation, having the ability to impact, with the goal of decreasing unnecessary emergency department visits/hospitalizations
- Overseeing an extended patient care team as assigned including but not limited to: Social Workers, Emergency Department Liaisons, Behavioral Health Liaisons, and Home Health Liaisons.
- Overseeing smooth Transitional Care Management for all patients discharged from in patient facility (hospital, skilled nursing/rehab, behavioral health) ensuring: Primary Care Provider visit, DME and Home Health Services, Specialist appointments, and community resources/social services are provided as indicated.
- EnsuringQuality Measures are reviewed and addressed when applicable/appropriate
- Implementing and directing Health Plan Health Education Activities for beneficiaries, providers, and staff
- Participatingin Care Coordination and Quality Committees, Primary Care Provider Meetings, and other meetings as required
- Monitoring corporate initiatives and strategies to achieve utilization of business and financial goals
- Managingthe successful integration of ACO Programs into current operations to meet the goals of all stakeholders
- Maintaining collaborative relationships with business partners both within the company and the community
- Managingand execute organizational opportunities and implement changes that are in alignment with corporate financial goals and strategic endeavors.
- Managing departmental expectations: staff hiring, orientation, auditing, and reviews; time management; motivation; and performance improvement
- Prioritizingof data, tasks, and requirements: Project management with expertise in departmental tasks and processes
- Representingfor health plan audits with development of actions plans for individual clients as needed to ensure compliance and incentive payouts
- Overseeing all projects, productivity, daily tasks and PHM activities in an organized and efficient manner
- Ensuringaccess to EMR systems for department staff
- Monitoring staff maintenance of HIPPA regulations
- Communicatingwith health plan contacts, customer Administrators and Client Business Managers to ensure resolution of any concerns.
- Identifyingand disseminating of Health Plan announcements applicable to Case Management
What You’ll Need To Have
- RN/BSN required
- 5 years of management experience
- 4 years clinical nursing experience
- At least 4 years of extensive experience in chronic care case management in outpatient setting
- Certification in case management preferred
- Must be able to work remotely and obtain state licensure in Illinois, Georgia, Pennsylvania, and Texas
- Must feel comfortable and confident leading a team of certified but unlicensed personnel and Registered Nurse case managers
- Ability to read, analyze, and interpret the most complex documents. Ability to respond effectively to the most sensitive inquiries or complaints.
The salary for this role is $95,000.00 per year.
BENEFITS:
All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:
- Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.
- Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.
- Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.
- Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.
- Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.
- Take Time for Yourself: We offer Flexible Time Off tailored to meet your needs and the needs of the business, helping you achieve work-life balance and meet your personal goals.
- Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.
- Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.
The listed compensation range listed is paid bi-weekly per our standard payroll practices.Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT
Diversity, inclusion, and belonging are at the core of Guidehealth’s values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.
Our Comittment To Protection Of Patient And Company Data
This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth’s custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.
Remote Work Technical Requirements
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The recommended internet speed is a minimum of 50 mbps download, 10 mbps upload. Please consult with your internet provider or run a speed test hereto confirm your internet connection meets these requirements.
Salary : $95,000
