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Case Management Advisor CMP

Location: Buffalo, NY, United States
Date Posted: Jan 2, 2020

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Job Description

Facility: Administrative Regional Training Cntr

Status: Full Time

Work Schedule: Days

Bargaining Unit: ACE Associates

Exempt from Overtime: Exempt: Yes

Hours: 8-4

Shift: Shift 1:

FTE: 1.000000:



Summary:


The Care Management Advisor is responsible for developing a comprehensive population health management approach for CMP practices in alignment with the CMP Clinical Integration Program to meet the Triple Aim (improved quality of care, improved affordability and improved patient satisfaction). The Care Management Advisor is a leadership role for population health management initiatives, population stratification process, managing transitions in care, registry development, and closing gaps-in-care. The Care Management Advisor is accountable for practices meeting effectiveness and efficiency goals. She/he prepares and presents progress towards defined goals to practice leaders and develops practice specific work plans for clinical process improvement, optimizing team based care, adherence to evidence based care, and patient engagement. Practice data is analyzed and interpreted to inform future performance improvement initiatives. The Care Management Advisor leverages health information technology to improve patient care and practice population health management within assigned practices.



The Care Management (CM) Advisor is responsible for implementing Catholic Medical Partners' care management and clinical integration programs. The CM Advisor teaches, mentors and supports practice based care teams to deliver high quality and well-coordinated care aimed at improving quality and utilization measures set forth by CMP.



The CM Advisor will support practices in the following:
  1. Identifying complex, high risk patients and providing care management.
  2. Implementing care management interventions including pre visit planning, coaching, patient advocacy, performing assessments and developing patient centric care plans, monitoring outcomes and analyzing practice results to incorporate continuous improvement strategies.
  3. Supporting practices in preparation for and achieving NCQA Patient Center Medical Home (PCMH) recognition
  4. Partnering with CMP physician leadership to provide resources and education to improve clinical quality and utilization performance.
  5. Analyzing and interpreting data and developing clinical performance improvement strategies in collaboration with the physician practice.

The Care Management Advisor must demonstrate excellent clinical, interpersonal, teaching and problem solving skills and the ability to communicate complex concepts in a clear, concise manner to all levels within a physician practice (e.g. physician leadership, clinical staff and support staff).

Responsibilities:


EDUCATION
  • Current and unrestricted New York State RN License
  • Bachelor of Science in Nursing preferred
  • Bachelor degree in a clinical discipline with 2 (two) years relevant work experience (public health, practice management, quality management, health promotion, etc.)
EXPERIENCE

  • Three (3) years of experience in a clinical setting required

  • Education and training experience required

  • Quality or Care Management experience preferred

  • Facilitative leadership of diverse teams experience preferred

  • Working knowledge of continuous improvement principles preferred

  • Health management experience for populations of patients preferred

KNOWLEDGE, SKILL AND ABILITY
  • Demonstrated ability to be creative, innovative, collaborative, self-directed, take initiative, motivate and inspire others
  • Understanding and ability to educate others on process improvement principles for clinical transformation
  • Demonstrated ability to learn new technologies including, but not limited to EMR, Population Health Management and data analytic tools
  • Knowledge of population health management principles
  • Knowledge of national quality of care measures (i.e. HEDIS, STAR)
  • In depth clinical knowledge of prevalent chronic conditions
  • Demonstrated ability to interpret data, information and survey results to drive decisions and focus interventions
  • Demonstrated ability to educate office based care teams to utilize data in developing their practice improvement plans
  • Demonstrated ability to manage multiple priorities and manage time effectively in a fast paced environment
  • Ability to function autonomously in a physician office based role
  • Ability to discern when to seek direction and/or escalate an issue
  • Ability to educate and advise professional staff, including nurses, mid-levels and physicians
  • Ability to develop and maintain strong, effective working relationships with CMP Medical Leadership, CMP physicians, practice staff, inpatient care management, home care, community based care, CMP and health plan staff to improve care management across continuum
  • Knowledge and understanding of accreditation and regulatory requirements
  • Electronic medical record experience
  • Knowledge and understanding of how to utilize evidence based guidelines, best methods for engaging and activating patients in self-care, patient registries, community resources and electronic health records to improve patient care
  • Ability to develop, deliver and facilitate group presentations and education
  • Knowledge of value based reimbursement models (i.e. partial capitation, financial risk arrangements)
  • Microsoft office program proficient (Excel, Word, PowerPoint)

WORKING CONDITIONS
  • Normal heat, light space, and safe working environment; typical of most office jobs


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