Care Delivery Manager

Job Purpose

Responsible for supporting the nursing standards of excellence with advance professional education to deliver high-quality care. Serve the organization as a member of the management team, working alongside with all departments and employees to support and oversee the day-to-day operations. Provide guidance, and deliver best practices in achieving organization's objectives, goals, and mission. Cultivate an environment dedicated to improving experience, enhancing satisfaction and retention.

Provides care coordination in a manner that is sensitive to age, gender, sexual orientation, cultural, linguistic, racial, ethnic, religious backgrounds, and congenital or acquired disabilities.

Review and ensure effective development and execution of personalized care plans that result in improved satisfaction & outcomes for all participants. Facilitate and complete the process of Interdisciplinary Team (IDT) meetings, Service Delivery Requests (SDR) and other meetings. This includes completing the attestations, as needed. Support and collaborate with the Virtual IDT as needed. Serve as a manager on call during non-operational hours of the physical sites and responsible for follow ups including follow up documentation and initiating grievances on participants/caregivers’ behalf in timely manner.

Responsible for running necessary Clinical Delivery reports. Participate and represent the Community Health Nurse (CHN) in all IDT meetings, when required. Balance and allocate staffing and related resources throughout the site and ensure adequate team assignments and coverage as a seamless operation. Responsible for ongoing communication with IDT and necessary parties involved to coordinate care consistent with the participants’ health care needs and goals to support in attaining and maintaining optimal health status.

Collaborate with clinicians to review UAS and the UAS analyzer system to ensure accuracy of their assessments. Ensure all incidents are investigated and addressed accordingly. Ensure Level 2 investigation and documentation are completed in a timely manner according to the CLHC regulation. Ensure documentation for participants are complete, accurate, including and not limited to enrollment, disenrollment, electronic/paper medical record, and any other clinical notes.

Review participants’ charts for quality and address any deficiencies. In collaboration with the Transitions in Care Team, provide care management services across sites and communicate with appropriate team members, facility, discharge planner, and home care coordinator when members are transitioned between care settings. Coordinates, facilitates, and arranges for long-term care services in nursing homes, rehab facilities, etc. as needed. Monitor care management activities, services, and members’ responses to interventions to determine the effectiveness of the plan of care and the utilization of services and implements changes and adjustments to meet needs and goals.

Ensure documentations are in accordance with CLHC standards and federal/state regulations. Maintain up-to-date knowledge about current health-related issues, procedures, evidence-based clinical practices guidelines, medications, and impacting health and practice standards. Recommend and contribute to improvements in services, programs, policies, and procedures to ensure optimum care and services to members. Collaborate with Human Resources Department (HR) in conducting Interviews, coaching and disciplinary action if needed.

Assist in onboarding and professional development training of staff to ensure compliance with policies/procedures/regulations as well as developing a continuous learning environment focused on growth and continued…