MAJOR RESPONSIBILITIES:??? 

1. Upholds and supports the mission, philosophy, objectives, policies and ethics of Community Health Systems, Inc (CHSI).? 
2. Plays a support role and may act as Primary RN Care Manager Role or Clinical Consultant as needed.?? 
3. Represents the ECM Provider.?? 
4. Responsible for promoting a collaborative and effective working environment within the care teams by engaging in evidence-based communication strategies when discussing responsibility of tasks, effectively resolving conflicts as they arise, and collaborating on Member case discussions.?? 
5. Assists with clinical audits for medical and behavioral health outcome measures in the?? 
6. web-based care management system or equivalent platform to ensure program compliance.? 
7. Participates in systematic caseload reviews.? 
8. Ensures smooth day-to-day operation of the team.??? 
9. Provide updates to the CM Program Manager regarding program requirements and achievements.??? 
10. Ensures maximum productivity of program and staff.??? 
11. Completes annual performance evaluations, oversees timecards/ time off requests, and processes expense reports of staff.??? 
12. Models the highest ethical behavior in relationships with co-workers, supervisors, members, providers, and colleagues in the community and within the organization.?? 
13. Participates in staff meetings, training, committee meetings, or other activities as needed or as directed by CHSI and Managed Care Plans (MCP).?? 
14. Ensures the privacy and security of PHI (Protected Health Information) as outlined in policies and procedures relating to HIPAA compliance including attending annual compliance training.??
15. Any other duties as required to ensure Care Management operations are successful.??

SUPERVISORY RESPONSIBILITIES:??  

• Supervises Care Management teams? 

KNOWLEDGE, SKILLS AND ABILITIES:?? 

• Knowledgeable and skilled in evidence-based practices?? 
• Highly skilled in interpersonal communication, including resolving conflict with co-workers.??? 
• Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both.??? 
• A high standard of professionalism and professional ethics and conduct is always expected in speech, manner, attitude and appearance. ?? 
• Advanced leadership and team management skills.??? 
• Attention to detail and problem-solving skills.??? 
• Well-developed verbal and written communication skills and the ability to work cooperatively with diverse groups?? 
• Knowledge of company policies.??? 
• Intermediate computer skills specific to Excel, Word, EHR, portals ect.??? 
• Ability to deal effectively with changing situations and stressful environments.??? 
• Ability to perform tasks related to physical activity to complete the responsibilities of the position.?? 

EXPERIENCE AND EDUCATION:?? 

• RN unrestricted license required.??? 
• BSN Required? 
• A valid California driver’s license, a reliable car, valid automobile insurance, and a good driving history are required.??? 
• Experience in case management or supervisory experience preferred? 
• Minimum 1-year clinical experience in an acute care facility, skilled nursing facility, home health, or FQHC clinic setting preferred.?? 
• Enhanced Care Management: a MediCal benefit, experience preferred? 
• American Heart Association or American Red Cross BLS certification required?? 
• Must maintain continuing Nursing education requirements for licensure.?? 

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Under the general supervision of the Care Management (CM) Program Manager, this position is responsible for working effectively with, and as part of, the Care Management Department to ensure high quality, effective care management for members. This position provides oversight for all Care Management teams within the California Advancing and Innovation Medi-Cal (Cal AIM) and Medicare initiatives. The role collaborates with internal and external stakeholders ensuring the requirements of the program are met and compliant. The position works with a variety of professionals ensuring daily operations of the department are met successfully.