Landmark Health

RN Case Manager - Clinical Operations Specialist

Job Locations US-CA-Huntington Beach
Posted Date 3 days ago(7/31/2020 10:39 AM)
Category
Operations
Type
Regular Full-Time
Job ID
2020-4216

Overview

As a critical member of the Landmark Implementation team, the DELTA Clinical Operations Specialist will provide administrative and clinical support for new and existing Landmark markets.  He or she will provide hands-on tactical training for the new market NCMs and Care Coordinators, directly case manage their own panel during a new market transition and provide administrative support for the new market office. During non-implementation periods, the DELTA COS will provide mature market support needs. These support needs can include: NCM staff relief, assist with new onboarding and training of NCMs. In addition, they may be called upon to assist in special projects and other duties as assigned by their supervisor.

The DELTA Clinical Operations Specialist will work closely with other members of the Implementation Team and market leadership teams. The key success metrics for this position will be:

  • Multi-State (Compact) RN LIcensure preferred
  • Building a best-in-class NCM (Nurse Care Manager) and CC (Care Coordinator) team through training and hands-on mentorship
  • Implementing standardized clinical and operational best practices in each new market
  • Helping build the administrative infrastructure for a new Landmark office
  • Supporting market growth by directly case managing patients and as an interim partner to the assigned provider(s)
  • Identifying potential OWL’s for the market

This is a travel position, requiring up to 70-80% travel.  In between new market Implementations, this person may be asked to provide extra remote NCM support in an existing Landmark market.  This position reports to the Director of Clinical Integration and Education.

 

 

Responsibilities

 

  • Training and Teambuilding
    • Leads on-boarding process for new NCM’s and Care Coordinators in new markets; supports training needs in existing markets.
    • Participates in interview process for NCM and CC candidates as requested.
  •  
    • Conducts NCM and Care Coordinator training, including classroom training, EMR mentorship and job shadowing in new markets; reviews and reinforces onboarding training in existing markets as requested.
    • Completes NCM and Care Coordinator competency checks as appropriate.
    • Serves as a peer mentor and resource for new NCMs, helping them learn and understand the Landmark Clinical Model of Care, and master the “Landmark Way” of case management.
    • Acts as an ambassador for the Landmark culture, helping to build strong, mission-driven, high performance teams in fitting with the Landmark mission, vision and values.
  • Implementing Best Practices
    • Establishes and maintains comprehensive understanding of Landmark clinical and operational best practices.
    • Reinforces best practices with all team members through example, training and mentorship.
  • Building Administrative Infrastructure
    • In partnership with the Implementation leadership team, responsibility for setting up core pieces of administrative infrastructure prior to go-live in a new market.
    • Responsible for setting up the Medical Supply Closet and training the local team on managing and maintaining the Medical Supply Closet.
    • Create provider medical kits.
    • Ensure office is ready for team and patient care to begin, including helping stock office with all initial materials including office supplies and appropriate marketing materials.
    • Partner with the Director of Clinical Integration to support the health plan partnerships, build direct relationship with health plan case manager peers as appropriate
  • Patient Care
    • This position is accountable for identifying and developing innovative actions to meet the needs of the member from both the health care and psychosocial / socioeconomic dimensions of care as well as taking action to meet those needs.
    • The DELTA Clinical Operations Specialist utilizes nursing assessment skills and decision-making authority to make recommendation and direct member care to meet the needs of the member and support the care recommendations of the multidisciplinary care team, the member, family and caregiver.
    • Completes an initial member assessment on all new enrolled members, including a medical record review where available.
    • Develops  a plan of care to establish a collaborative approach to member needs across clinicians and care delivery.
    • Coordinates care across the continuum of care delivery model as the point of contact for member/caregiver and clinicians.
    • Acts as liaison between providers, nursing facilities, hospitals and program staff, including making recommendations about care alternatives or equipment that will aide in the safety of the member while promoting optimal clinical outcomes.
    • Obtain RN licensure in multiple states as requested, including assisting the Landmark credentialing team with timely and responsive processing of all required licensing / credentialing paperwork.
    • Acts as an advocate for the member in all activities including nursing assessments, care coordination, care plan development, and communication.
    • When functioning in a supportive/NCM staff relief role:

 

  • Participates in team meetings that include, but may not be limited to:
    • Weekly IDT meetings
    • Monthly staff meetings
    • Continuing education/journal club programs
      • When overseeing a panel, monitors patients during admissions to both acute and skilled level of care to support member needs, acts as the point of contact to clinicians and member/responsible party/families to ensure consistent and ongoing communication between all involved parties.
      • Serves as a resource to the entire care delivery team.
      • Identifies and reports/escalates  any quality of care issues to direct supervisor and market HSD.
      • Completes a “Market Visit Summary” within 48 business hours of a mature market assignment, and shares  with the market HSD and Regional DCO.

Qualifications

  • Current RN License, BSN preferred
  • 5 or more  years of clinical practice in a hospital, clinic, home care
  • Case management experience preferred
  • Leadership experience desired – can be from a leadership role or lead for a special project or workgroup
  • Disease management experience required
  • Physician office experience helpful
  • Health plan, NCQA, and Complex Care Management experience preferred
  • 1 year of experience in the NCM role at Landmark is a plus.

 

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