Primary City/State:

Arizona, Arizona

Department Name:

ALTCS CM

Work Shift:

Day

Job Category:

Clinical Care

The future is full of possibilities. At Banner Plans & Networks, we’re changing the industry to reduce healthcare costs while keeping members in optimal health. If you’re ready to change lives, we want to hear from you.

Banner Plans & Networks (BPN) is an integrated network for Medicare and private health plans. Known nationally as an innovative leader, BPN insurance plans and physicians work collaboratively to keep members in optimal health while reducing costs. Supporting our members and vast network of providers is a team of professionals known for innovation, collaboration, and teamwork. If you would like to contribute to this leading-edge work, we invite you to bring your experience and skills to BPN.

In the role of Senior Manager of RN Case Management, you will oversee a team of five Registered Nurses responsible for the clinical management of our 6900 ALTCS members. This includes the oversight of complex cases, including members in nursing facilities and those with high needs or high utilization. You may also follow members to ensure adherence to quality measures like diabetic testing. You will collaborate with other ALTCS leadership to provide care for our elderly and physically disabled members.

The position is fully remote, with work hours from Monday to Friday during business hours in the Arizona Time Zone. If you're interested in this role, we encourage you to apply today!

Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY

This position plans and provides managerial and/or clinical support to patients, staff and leadership within the department. This position supervises employees and participates in selection, orientation, counseling, evaluation and staff scheduling. Maintains a depth and breadth of clinical competency and/or managed care knowledge to assess outcomes related to delivery of Case Management services.

CORE FUNCTIONS

1. Provides and/or facilitates case management and/or other related activities and serves as a resource to other staff members. Promotes interdisciplinary patient care planning and supports Care Model.

2. Hires, trains, conducts performance evaluations, and directs the workflow for the staff. This position is also accountable for participating in the development and implementation of department goals and objectives. Ensures all goals and objectives are met timely and effectively.

3. Serves as a resource and provides leadership assistance to achieve optimal clinical, operational, financial, and satisfaction outcomes. Acts as a consultant within the organization and perhaps in the community.

4. Supports change and participates in the development, implementation and evaluation of the goals/objectives and process improvement activities within the department. Works with staff to make necessary changes. May analyze data and healthcare trends to gain efficiencies and improve patient outcomes.

5. Participates in the development of the department budget in conjunction with established goals and objectives. Plays a key role in ensuring budgetary goals are met on an annual basis.

6. Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional societies.

7. This position is facility/entity based, providing leadership within case management to ensure quality outcomes and resource efficiency. Internal customers include all levels of nursing leadership and staff, medical staff and all other members of the interdisciplinary healthcare team. External customers include physicians, payers, community agencies, provider networks and regulatory agencies.

MINIMUM QUALIFICATIONS

BSN or MSN required for all new hires to the position after October 1, 2016. Incumbents in the position as of October 1, 2016, must possess their by BSN or MSN July 1, 2018.

Requires current Registered Nurse (R.N.) license in state worked.

Requires extensive knowledge in the areas of case management and utilization management. Must have a working knowledge of hospital operations, medical/nursing staff procedures, hospital and community resources. Requires excellent leadership skills and an ability to interact well across departments, facilities and organizations. Excellent organizational, human relations, and communication skills are required to maintain good rapport and effective working relationships with internal and external customers. In BPA (Benefits Plan Administration) setting, requires an understanding of reimbursement methodologies.

PREFERRED QUALIFICATIONS

Additional related education and/or experience preferred.

Arizona Long Term Care Services (ALTCS) experience preferred.

Prior RN leadership preferred.

EEO Statement:

EEO/Female/Minority/Disability/Veterans (https://www.bannerhealth.com/careers/eeo)

Our organization supports a drug-free work environment.

Privacy Policy:

Privacy Policy (https://www.bannerhealth.com/about/legal-notices/privacy)

EOE/Female/Minority/Disability/Veterans

Banner Health supports a drug-free work environment.

Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability