Qualifications:
Qualifications: Education: • Registered Nurse, RN license in the state of MA • Bachelor's degree or an equivalent combination of education, training and experience is required Preferred/Desirable: • Certification in case management (CCM) preferred • Experience in acute care and/or rehab care/case management. • Experience with Medicaid/Medicare recipients and community services. • Experience with healthcare care management database. • Experience managing a remote workforce • Experience with the Medicaid, Medicare, and / or Senior population • Experience with ASAPs preferred Experience: • 1 year of prior supervisory experience • 2 years-experience with case management, care coordination, long term services and supports and/or discharge planning, MDS assessments, preferably with a Senior Care Options Plan/for the elderly population.

Responsibilities:
The Supervisor of Care Management, Senior Care is responsible for the daily supervision and operations of the SCO Care Management team as the team carries out requirements of the SCO Model of Care and contractual requirements of CMS and Mass Health. This will include day-to-day mentoring and oversight of Registered Nurse Care Managers, Social Work Care Managers, Care Coordinators, Community Health Workers, and new hires. Assigns work, ensures compliance with policies and procedures and is the first point of contact for complex issues to ensure cost-effective, quality, and safety, as the senior population accesses services throughout the continuum of care to include those living in the home environment with community integration, other residential care communities and/or skilled nursing facilities. Under the direction of the Manager of Care Management, Senior Care, uses available data to prioritize timeliness of assessments that may include Health Risk Assessments, MDS-HC and/or MDS-3.0, and ensures that individualized plans of care (IPC) are established with the Primary Care Team (PCT). The Supervisor is responsible for the appropriateness throughout the continuum to include institutional long term care services and developing community-based ICPs for Enrollees, ensuring (PCT) integration. The Supervisor will perform staff audits, as developed by the CM Manager and Trainer, perform ongoing staff coaching, identify opportunities for additional staff training, and inform the Manager of CM, SCO, of individual staff results which may lead to performance improvement plans (PIP's). S/he will carry out interventions within PIP's, as established in collaboration with the Manager. S/he may carry a caseload, per business needs. This position ensures that department processes, policies and procedures are adhered to consistently. The Supervisor will accompany and mentor CM staff working in the field, from time to time, in collaboration with the Manager. The Supervisor works in close partnership with the CM Trainer, Clinical Vendor Managers, LTSS Coordinator, ASAP Vendor Manager, and UM Specialists and will become strongly knowledgeable of all departments throughout BMCHP and their responsibilities to the SCO population, carrying out internal integration points as built by the Manager and Trainer of CM across the Office of Clinical Affairs (OCA). The Supervisor will also become proficient in the full contractual requirements of the SCO agreement to include workforce, operations, reporting and measurements and other. The Supervisor will become proficient in the BMCHP systems required for implementation of the SCO contract. The Supervisor will become proficient in contracts with vendors and agencies of whom BMCHP outsources for the SCO population. As requested by the Manager of CM, the Supervisor will attend and participate in meetings with internal and external stakeholders and ensure the staff carries out processes as they are built that will be necessary for a successful SCO program. Under the direction of the Manager, the Supervisor may participate in external SCO program reviews such as readiness, External Quality Review Organization (EQRO) reviews, other. Key Functions/Responsibilities: • Monitors and evaluates the quality, timeliness and accuracy of MDS and HRA assessments, Individual Care Planning and Integrated Care Team review and approval. • Collaborates with the inpatient utilization management team, and the LTSS coordinator, ASAP vendor manager and , CM trainer. • Develops strong relationships with providers, community and social service organizations to ensure that Enrollees have access to the range of supportive services in accordance with the ICP • Participates in staff hiring, work allocation, training, performance management in collaboration with the Manager of CM, professional development and related supervisory functions. • Consults with the Manager of CM, Trainer, and staff to identify/implement workflow and process improvements to maximize quality, efficiency and cost effectiveness of the team • Assists with and participates in the planning, development and implementation of SCO CM department specific and cross functional projects. • Supports CM initiatives through communication strategies, team leadership, facilitation and recommendations. • Responsible for tracking interventions to address opportunities for improvement in overall CM performance. • Under the direction of and in collaboration with the Manager of CM, develops and uses metrics and management reports to monitor staff productivity and efficiency. • Accountable for timely notification to the Manager if staff performance falls below expectations, and works with leadership to develop an improvement plan to improve. • Identifies members who could benefit from multidisciplinary rounds. • Enters data accurately, timely, and completely; documents all encounters according to the department policies and workflows and complies with contractual requirements regarding turn-around-times. • Conducts routine audits to monitor compliance with workflows, job aids, and activities. • May maintain caseload volume and turnaround times meeting department productivity standards, as per collaboration with Manager and per business need. • Provides high level of service and satisfaction to internal and external customers.
• Monitors case inventory and team members' workload and adjusts as necessary. • Responds to staff issues and concerns raised by staff and escalates to management as appropriate. • In conjunction with CM Trainer and Manager, assists with orientation onboarding new hires and on-going role specific training , including development of training materials as it relates to SCO CM. • Other functions as required to support departmental activities. Supervision Exercised: • Responsible for the supervision of 7-10 Care Management clinical and non-clinical staff for the Senior population

Comments/Special Instructions
The end date of this position is unknown at this time, but could go out as far as late December.