Manager, Clinical Care - TCM

What You’ll Do 

The Manager of Clinical Care in the Transitional of Care Management (TCM) team provides direct supervision of the RNCMs in the management of complex CKD and ESRD patients referred into the program. This Manager of TCM helps with training and chart auditing to ensure NCQA accreditation guidelines are met. This individual assists with efforts to develop, implement, evaluate, redesign, and modify TCM practice standards and works closely with the TCM staff to assist patients safely, effectively, and efficiently across and through the continuum of care. This position reports to Sr. Director, Transition of Care. 

 The Day to Day 

• Supervises daily operations of the TCM Case Management staff directed by the TCM Senior Director.  

• Manages the RNCM team to meet daily activity and performance metrics. 

• Helps conduct employee performance reviews, monitors, and mentors TCM staff. 

• Helps Coordinate daily flow of the TCM team (this includes overseeing PTO requests, assignment coverage, on-call coverage). 

• Functions as a resource person for the TCM processes pertaining to NCQA and CCM efforts. 

• The Clinical manager of TCM will attend regional market meetings including client facing meetings as needed to represent the TCM program. 

• Facilitates regional TCM rounds in collaboration with regional clinical teams including regional medical directors. 

• Collaborates with all levels of the clinical team to improve processes, communication, and team skills needed to provide the best care to our patients to ensure safe/effective/efficient plans of care are implemented 

• Monthly 5-10% of RN or NP charts will be audited to ensure quality care is being provided to our patients in accordance with our program description.  Performance management of clinical staff that are not meeting the quality audit expectations is a critical part of the clinical manager's role. 

Minimum Qualifications 

• Associate’s degree from accredited school of nursing. 
• 8 years combined of related education, experience, or certification. 
• 1 year of supervisory/management experience.
• 2 years experience working with NCQA CCM accreditation. 
• 2 years complex care management or transitions of care experience or equivalent experience in healthcare environment. 
• Current Registered Nurse (RN) license in the state of practice required (position may require licensure in multiple states within a region). 
• Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms. 
• Travel for in-person on-sites required <10% annually. 

Preferred Qualifications 

• Certified Case Manager (CCM) certification preferred. 

• Current knowledge of CKD/ESRD or Complex CM processes preferred.  

• Managed/Value-Based Care and payor experience preferred. 

About You 

• Able to use expert clinical practice, leadership skills, and critical thinking skills to efficiently coordinate and direct patient care among all health care providers while maximizing use of resources. 

• Excellent communication and interpersonal skills. 

• The motivation and drive to work independently with minimal supervision to pursue continuous development of self and others are required. 

• Ability to foster principles of participative management by identifying/involving relevant individuals in program-related decisions is required. 

• Ability to apply creative and innovative approaches to help develop and maintain systems that achieve higher levels of multi-disciplinary team performance and desired patient outcomes is needed. 

• Strong analytical skills. 

  Annual Base Salary Range: $86,000 - $104,000

Salary : $86,000 - $104,000