CalAIM LVN Nursing Supervisor

Description

GENERAL PURPOSE:

 

 

Under the supervision of the Enhanced Care Coordination (ECC) Program Manager, the CalAIM LVN Nursing Supervisor is responsible for the day-to-day operation and supervision of the CalAIM program and staff, and the ongoing performances of Lead Case Managers, ensuring all KPIs are met. This position will oversee team duties related to enhanced care management and comprehensive care planning to address both clinical and nonclinical needs, ensures program staff meet regularly, and program activities are integrated with clinic workflows and operations. May perform nursing functions as related to patient care, including medical assessment when needed. Is responsible for maintaining a culturally sensitive environment for all ethnicities represented in the patient population.

 

 

MAIN RESPONSIBILITIES & DUTIES:

 

1. Maintains staff schedules and scheduled appointments to a level that supports agency productivity standards and key performance indicators.
   1. Ensures continued growth of the program by supporting efforts in increasing staff capacity, expanding available resources through community partners, and improving overall health of patients.
   2. Ensures Lead Case Managers are actively conducting outreach to members in all the populations of focus and completing enrollment by submitting Treatment Authorization Requests (TARs) for members in need of CalAIM services. Assists staff in quickly building up to a high case load capacity.
   3. Ensures Lead Case Managers are successfully engaging and providing services to all enrolled members monthly. Successfully billing for services rendered for all enrolled members.
   4. Assists in coordinating lower levels of care to members that have successfully completed all goals, shown they are able to self-managed care, and no longer in need of Lead Case Manager services.
2. Assists with the supervision of the Lead Case Managers, providing guidance and support to ensure daily operations run smoothly.
3. Assists Enhanced Care Coordination Program Manager in compiling and maintaining patient tracking lists from available data reports, such as patients being discharged from the hospital, and patients eligible for and/or enrolled in CalAIM Programs.
4. Monitors and prepares daily, weekly, and monthly reports on the program metrics to be reviewed with the Enhanced Care Coordination Program Manager and staff.
   1. Ensures Lead Case Managers meet individual goals such as maintaining high case load and successfully provided services to patients, and the CalAIM Program is on pace to meet monthly, quarterly, and annual measures and milestones.
5. Assigns daily potential patients and CalAIM referrals to Lead Case Managers.
6. Assists in adding new staff users to access dashboard portals utilized by the program staff.
7. Assists the CalAIM Clinical Consultant audit efforts to conduct no less than 5 random audits per Lead Case Managers per month, by performing audit on required tasks following program guidelines.
   1. Monitors the daily Appointment and Travel Logs completed by staff.
   2. Ensures all required documentation is completed and uploaded according to policies and procedures, such as Registration, Release of Information, Care Plans, and screening forms.
   3. Ensures all appointments, chart notes, and care plans are completed according to policies and procedures.
   4. Ensures all appointments follow billing procedures, contain confirmation of the approved TAR number, CalAIM referral and Case are completed and attached to the visit, and the correct billing codes and diagnosis codes are utilized.
   5. Ensure patient receives excellent services.
8. Assists the CalAIM Clinical Consultant in providing in-service training to Lead Case Managers, providers, and nursing staff regarding CalAIM services, procedures, and forms.
9. Assists in facilitating weekly and monthly meetings, maintaining accurate records of staff sign-in sheet, meeting notes, action items, and storing meeting records in a location accessible by all staff.
10. Provides input to the Enhanced Care Coordination Program Manager on program guidelines for continuous development and improvement of services and outcomes to patients.
11. Communicates with Call Center Manager, Call Center Assistance Managers, and Call Center Operator to ensure incoming and outgoing calls and telephone encounters are timely addressed by appropriate staff.
12. Assists the Enhanced Care Coordination Program Manager in recruiting, hiring, orienting, and terminating of Lead Case Managers.
13. Assists the Enhanced Care Coordination Program Manager in Annual Evaluations, and handling Key Incidents as needed for both recognition and disciplinary purposes for Lead Case Managers.
14. Reviews and approve Lead Case Managers’ timecards, includes approving PTO requests for Lead Case Managers based on the CalAIM staffing daily needs
15. Assists the Enhanced Care Coordination Program Manager in providing timely resolution to conflicts or direction of patient complaints regarding the CalAIM Program.
16. Responsible for maintaining CalAIM Ampla Health vehicles, by acting as liaison to the Transportation Manager.
    1. Schedule routine vehicle maintenance and as needed.
    2. Ensure program staff follow policies and procedures related to company vehicles and traveling during work hours.
    3. Ensures staff complete the Whiparound app weekly and as needed, vehicles are kept clean and washed daily, vehicles are refueled for next day usage, tracking staff mileage reimbursement requests.
17. Assists Enhanced Care Coordination Program Manager in ordering and maintaining adequate inventory of office supplies and equipment for CalAIM staff.
18. Assists the Enhanced Care Coordination Program Manager and the CalAIM Clinical Consultant in all Quality Management (QM) activities.
19. Exhibits flexibility and willingness to perform duties and tasks as a patient support staff.
20. Utilizes verbal and written communication that enhances team effort and growth.
21. Resumes duties of vacant Lead Case Manager positions with Ampla Health as needed.
22. Performs nursing functions related to patient care such as health education, health screenings, care coordination, and care planning. Link patients to the CalAIM Clinical Consultant for medical assessment and triage as needed.
23. Performs other duties as assigned by supervisor.

 

QUALITIES & CHARACTERISTICS

 

1. Maintains a professional relationship and positive attitude with co-workers, the public, patients and all Ampla Health’s staff, Board of Directors and vendors
2. Maintains the highest professional ethics and is honest in dealing with people; is a model for all employees through his/her actions
3. Ability to deal with cultural differences relative to health issues.
4. Strives to learn more and is receptive to new challenges and opportunities
5. Displays enthusiasm toward the work and the mission of Ampla Health
6. Treats all clients, staff, and the community with respect and courtesy
7. Demonstrates clear knowledge of Ampla Health’s clinic structure, standards, procedures and protocols

 

QUALIFICATIONS, PROFESSIONAL KNOWLEDGE, SKILLS & ABILITIES

 

1. Valid California LVN License issued by the Board of Vocational Nurses required
2. Current CPR certification required
3. Previous experience in a healthcare setting, with specific experience in case management and care planning preferred 5 years minimum
4. One year experience desired in a supervisory role, with proven leadership abilities in staff supervision, training, and team development.
5. Strong understanding of medical terminology, treatment authorization request (TAR) requirements, and regulatory requirements related to case management.
6. Proficiency in electronic health records (EHR) systems and Care Plan module.
7. Excellent interpersonal skills with the ability to communicate effectively with patients, healthcare providers, and administrative staff.
8. Ability to use discretion in situations dealing with confidential patient information
9. Detail-oriented and organized, with the ability to prioritize tasks and manage multiple responsibilities simultaneously
10. Maintains expertise in the CalAIM programs, services, eligibility, enrollment, and billing process.
11. Demonstrates clear knowledge of community resources, coordinating services with local and regional agencies, and willingness to expand community network.

 

COMMUNICATIONS SKILLS:

 

1. Must have neat and legible handwriting
2. Must be able to interact with patients courteously and calmly
3. Ability to communicate well with the public
4. Utilizes effective verbal and written communication skills

 

WORKING CONDITIONS & PHYSICAL REQUIREMENTS:

 

Works well with patients in a generally comfortable environment office, at the patients’ home, outside at a specific location such as street or encampment, or at an agreed upon safe location. Employees must possess the following physical requirements:

 

1. Must be able to travel and provide services at locations where patients reside
2. Must be able to lift up to 40 pounds and push up to 100 pounds (on wheels)
3. Able to work on feet the majority of the day without tiring
4. Must be able to hear and communicate with clients and staff on the telephone and those who are served in person, and speak clearly in order to communicate information to clients and staff
5. Must have manual dexterity adequate to read increments on tuberculin syringe accurately
6. 
   Must have high manual dexterity and tactile sensation on fingertips
7. Routinely exposed to blood borne pathogens

1. May be subjected to verbally and/or physically abusive patients
2. Must have vision, which is adequate to read memos, computer screens, registration forms and other clinic documents
3. Must be able to reach above shoulder level to work. Must be able to bend, squat and sit, stand, stoop, crouch, reach, kneel, twist/turn
4. May be exposed to contagious/infectious diseases

Qualifications

GENERAL PURPOSE:

 

 

Under the supervision of the Enhanced Care Coordination (ECC) Program Manager, the CalAIM LVN Nursing Supervisor is responsible for the day-to-day operation and supervision of the CalAIM program and staff, and the ongoing performances of Lead Case Managers, ensuring all KPIs are met. This position will oversee team duties related to enhanced care management and comprehensive care planning to address both clinical and nonclinical needs, ensures program staff meet regularly, and program activities are integrated with clinic workflows and operations. May perform nursing functions as related to patient care, including medical assessment when needed. Is responsible for maintaining a culturally sensitive environment for all ethnicities represented in the patient population.

 

 

MAIN RESPONSIBILITIES & DUTIES:

 

1. Maintains staff schedules and scheduled appointments to a level that supports agency productivity standards and key performance indicators.
   1. Ensures continued growth of the program by supporting efforts in increasing staff capacity, expanding available resources through community partners, and improving overall health of patients.
   2. Ensures Lead Case Managers are actively conducting outreach to members in all the populations of focus and completing enrollment by submitting Treatment Authorization Requests (TARs) for members in need of CalAIM services. Assists staff in quickly building up to a high case load capacity.
   3. Ensures Lead Case Managers are successfully engaging and providing services to all enrolled members monthly. Successfully billing for services rendered for all enrolled members.
   4. Assists in coordinating lower levels of care to members that have successfully completed all goals, shown they are able to self-managed care, and no longer in need of Lead Case Manager services.
2. Assists with the supervision of the Lead Case Managers, providing guidance and support to ensure daily operations run smoothly.
3. Assists Enhanced Care Coordination Program Manager in compiling and maintaining patient tracking lists from available data reports, such as patients being discharged from the hospital, and patients eligible for and/or enrolled in CalAIM Programs.
4. Monitors and prepares daily, weekly, and monthly reports on the program metrics to be reviewed with the Enhanced Care Coordination Program Manager and staff.
   1. Ensures Lead Case Managers meet individual goals such as maintaining high case load and successfully provided services to patients, and the CalAIM Program is on pace to meet monthly, quarterly, and annual measures and milestones.
5. Assigns daily potential patients and CalAIM referrals to Lead Case Managers.
6. Assists in adding new staff users to access dashboard portals utilized by the program staff.
7. Assists the CalAIM Clinical Consultant audit efforts to conduct no less than 5 random audits per Lead Case Managers per month, by performing audit on required tasks following program guidelines.
   1. Monitors the daily Appointment and Travel Logs completed by staff.
   2. Ensures all required documentation is completed and uploaded according to policies and procedures, such as Registration, Release of Information, Care Plans, and screening forms.
   3. Ensures all appointments, chart notes, and care plans are completed according to policies and procedures.
   4. Ensures all appointments follow billing procedures, contain confirmation of the approved TAR number, CalAIM referral and Case are completed and attached to the visit, and the correct billing codes and diagnosis codes are utilized.
   5. Ensure patient receives excellent services.
8. Assists the CalAIM Clinical Consultant in providing in-service training to Lead Case Managers, providers, and nursing staff regarding CalAIM services, procedures, and forms.
9. Assists in facilitating weekly and monthly meetings, maintaining accurate records of staff sign-in sheet, meeting notes, action items, and storing meeting records in a location accessible by all staff.
10. Provides input to the Enhanced Care Coordination Program Manager on program guidelines for continuous development and improvement of services and outcomes to patients.
11. Communicates with Call Center Manager, Call Center Assistance Managers, and Call Center Operator to ensure incoming and outgoing calls and telephone encounters are timely addressed by appropriate staff.
12. Assists the Enhanced Care Coordination Program Manager in recruiting, hiring, orienting, and terminating of Lead Case Managers.
13. Assists the Enhanced Care Coordination Program Manager in Annual Evaluations, and handling Key Incidents as needed for both recognition and disciplinary purposes for Lead Case Managers.
14. Reviews and approve Lead Case Managers’ timecards, includes approving PTO requests for Lead Case Managers based on the CalAIM staffing daily needs
15. Assists the Enhanced Care Coordination Program Manager in providing timely resolution to conflicts or direction of patient complaints regarding the CalAIM Program.
16. Responsible for maintaining CalAIM Ampla Health vehicles, by acting as liaison to the Transportation Manager.
    1. Schedule routine vehicle maintenance and as needed.
    2. Ensure program staff follow policies and procedures related to company vehicles and traveling during work hours.
    3. Ensures staff complete the Whiparound app weekly and as needed, vehicles are kept clean and washed daily, vehicles are refueled for next day usage, tracking staff mileage reimbursement requests.
17. Assists Enhanced Care Coordination Program Manager in ordering and maintaining adequate inventory of office supplies and equipment for CalAIM staff.
18. Assists the Enhanced Care Coordination Program Manager and the CalAIM Clinical Consultant in all Quality Management (QM) activities.
19. Exhibits flexibility and willingness to perform duties and tasks as a patient support staff.
20. Utilizes verbal and written communication that enhances team effort and growth.
21. Resumes duties of vacant Lead Case Manager positions with Ampla Health as needed.
22. Performs nursing functions related to patient care such as health education, health screenings, care coordination, and care planning. Link patients to the CalAIM Clinical Consultant for medical assessment and triage as needed.
23. Performs other duties as assigned by supervisor.

 

QUALITIES & CHARACTERISTICS

 

1. Maintains a professional relationship and positive attitude with co-workers, the public, patients and all Ampla Health’s staff, Board of Directors and vendors
2. Maintains the highest professional ethics and is honest in dealing with people; is a model for all employees through his/her actions
3. Ability to deal with cultural differences relative to health issues.
4. Strives to learn more and is receptive to new challenges and opportunities
5. Displays enthusiasm toward the work and the mission of Ampla Health
6. Treats all clients, staff, and the community with respect and courtesy
7. Demonstrates clear knowledge of Ampla Health’s clinic structure, standards, procedures and protocols

 

QUALIFICATIONS, PROFESSIONAL KNOWLEDGE, SKILLS & ABILITIES

 

1. Valid California LVN License issued by the Board of Vocational Nurses required
2. Current CPR certification required
3. Previous experience in a healthcare setting, with specific experience in case management and care planning preferred 5 years minimum
4. One year experience desired in a supervisory role, with proven leadership abilities in staff supervision, training, and team development.
5. Strong understanding of medical terminology, treatment authorization request (TAR) requirements, and regulatory requirements related to case management.
6. Proficiency in electronic health records (EHR) systems and Care Plan module.
7. Excellent interpersonal skills with the ability to communicate effectively with patients, healthcare providers, and administrative staff.
8. Ability to use discretion in situations dealing with confidential patient information
9. Detail-oriented and organized, with the ability to prioritize tasks and manage multiple responsibilities simultaneously
10. Maintains expertise in the CalAIM programs, services, eligibility, enrollment, and billing process.
11. Demonstrates clear knowledge of community resources, coordinating services with local and regional agencies, and willingness to expand community network.

 

COMMUNICATIONS SKILLS:

 

1. Must have neat and legible handwriting
2. Must be able to interact with patients courteously and calmly
3. Ability to communicate well with the public
4. Utilizes effective verbal and written communication skills

 

WORKING CONDITIONS & PHYSICAL REQUIREMENTS:

 

Works well with patients in a generally comfortable environment office, at the patients’ home, outside at a specific location such as street or encampment, or at an agreed upon safe location. Employees must possess the following physical requirements:

 

1. Must be able to travel and provide services at locations where patients reside
2. Must be able to lift up to 40 pounds and push up to 100 pounds (on wheels)
3. Able to work on feet the majority of the day without tiring
4. Must be able to hear and communicate with clients and staff on the telephone and those who are served in person, and speak clearly in order to communicate information to clients and staff
5. Must have manual dexterity adequate to read increments on tuberculin syringe accurately
6. 
   Must have high manual dexterity and tactile sensation on fingertips
7. Routinely exposed to blood borne pathogens

1. May be subjected to verbally and/or physically abusive patients
2. Must have vision, which is adequate to read memos, computer screens, registration forms and other clinic documents
3. Must be able to reach above shoulder level to work. Must be able to bend, squat and sit, stand, stoop, crouch, reach, kneel, twist/turn
4. May be exposed to contagious/infectious diseases

Salary : $34 - $49