Job Abstract

FlexStaff

Our client is seeking a Senior Clinical Operations Manager to join their management team and support their mission of excellence in care delivery. This role is integral to overseeing day-to-day operations, ensuring compliance with regulatory standards, and fostering a supportive and collaborative environment for staff and participants alike. Must have a Degree from an NLN accredited nursing school (RN, BSN required or at least 5 years experience in a healthcare setting).

Job Responsibilities:

• Develop and execute personalized care plans to enhance participant satisfaction and outcomes.
• Facilitate Interdisciplinary Team (IDT) meetings, Service Delivery Requests (SDR), and other essential meetings, including completing attestations as needed.
• Serve as a manager on call during non-operational hours, handling follow-ups and initiating grievances promptly.
• Run and analyze necessary Clinical Delivery reports.
• Represent the Community Health Nurse (CHN) in IDT meetings when required.
• Balance staffing and resources, ensuring seamless team assignments and coverage.
• Communicate with IDT and relevant parties to coordinate care, supporting participants in achieving optimal health.
• Collaborate with clinicians to review and ensure the accuracy of assessments using UAS and UAS analyzer systems.
• Investigate and address all incidents, ensuring Level 2 investigations and documentation are timely and compliant with CLHC regulations.
• Ensure complete and accurate documentation for participants, including enrollment, disenrollment, and medical records.
• Review participants charts for quality and address deficiencies.
• Work with the Transitions in Care Team to manage care across sites and communicate during care transitions.
• Coordinate long-term care services in nursing homes, rehab facilities, etc., as needed.
• Monitor care management activities and implement changes to meet participant needs and goals.
• Maintain up-to-date knowledge of current health-related issues, procedures, and evidence-based clinical practices.
• Recommend and contribute to improvements in services, programs, policies, and procedures.
• Collaborate with Human Resources for staff interviews, coaching, disciplinary actions, onboarding, and professional development.
• Evaluate work performance and competency of direct reports, provide feedback, and complete annual performance reviews.
• Ensure regulatory compliance at all federal and state levels.
• Investigate and resolve employee grievances and complaints.
• Serve as the Director of Patient Services (DPS) for the LHCSA as assigned.
• Meet standardized competencies for the position description established by the PACE organization.

Qualifications:

• Degree from an NLN accredited nursing school (RN, BSN required or at least 5 years experience in a healthcare setting).
• Successful completion of an accredited Nursing Program.
• Baccalaureate degree highly desired.
• Completed NYSED-approved infection control coursework.
• Minimum of 8.0 education contact hours, including mandatory training requirements such as infection control coursework.
• Case Management Certification recommended within 2 years of employment.
• 3-5 years of administrative experience in a management capacity in CHHA, LHCSA, acute care, medical-surgical, critical care, nursing home, diagnostic & treatment clinic.
• Customer service experience required.
• Managed long-term care insurance experience beneficial.
• Minimum of 1 year of experience working with a frail or elderly population, or appropriate training from the PACE organization.
• Supervisory experience required.
• Current active and unrestricted license and registration in New York State as a Registered Nurse.
• Legally authorized to practice in the State of New York.
• Medically cleared for communicable diseases and up-to-date immunizations.
• Bilingual preferred.

*Additional Salary DetailThe salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts,