Population Health Management Supervisor RN

POSITION SUMMARY/RESPONSIBILITIES

Provides supervision of quality activities delivered and facilitates the health care team meeting UMA strategic goals and established metrics for the assigned patient population/s. Provides professional level skills affording direct and indirect services to clients and working with a multidisciplinary team to streamline data submission to managed care plans, educate Physicians and Advanced practice providers and promote optimal well-rounded care for assigned patient population in the outpatient setting. Establishes priorities for self and peers, ensuring that services are rendered in a prompt, efficient and effective manner. Actively supports the policies and procedures of UMA and University Health.

EDUCATION/EXPERIENCE

Five years of applicable experience

• required with a Licensed Vocational Nurse (LVN); OR six years of applicable experience with an Associates of Science in Nursing (ASN); OR five years of applicable experience
• required with a Bachelor's of Science in Nursing (BSN)
• Applicable experience for this position is defined as, but not limited to, experience in acute care, quality management, managed care, medical operations or business operations/settings.

Knowledge of coding resources (DRG, ICD and CPT) and Medical Information/Medical Management Systems is required. Knowledge of Medicaid, community resources, alternate funding programs, Texas Health and Human Services Commission and Texas Department of Insurance HMO standards and NCQA in a managed care setting is required. Supervisory experience is preferred.

LICENSURE/CERTIFICATION

Clinicians serving as a supervisor must hold/maintain current licensure requirements in his/her specialty with the State of Texas. All staff serving as a supervisor must maintain a current certification from an appropriate professional agency (such as Case Management Society, Six Sigma, Project Management, etc.) or must be obtained within 24 months of accepting the position.