Population Health Management Supervisor RN in San Antonio, Texas at University Health System- San Antonio
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Job Description
POSITION SUMMARY/RESPONSIBILITIES
Provides supervision of quality activities delivered and facilitates the health care team meeting UMA strategic goals and established metrics for the assigned patient population/s. Provides professional level skills affording direct and indirect services to clients and working with a multidisciplinary team to streamline data submission to managed care plans, educate Physicians and Advanced practice providers and promote optimal well-rounded care for assigned patient population in the outpatient setting. Establishes priorities for self and peers, ensuring that services are rendered in a prompt, efficient and effective manner. Actively supports the policies and procedures of UMA and University Health.
EDUCATION/EXPERIENCE
Five years of applicable experience* required with a Licensed Vocational Nurse (LVN);
OR six years of applicable experience with an Associates of Science in Nursing (ASN);
OR five years of applicable experience* required with a Bachelor’s of Science in Nursing (BSN)
*Applicable experience for this position is defined as, but not limited to, experience in acute care, quality management, managed care, medical operations or business operations/settings. Knowledge of coding resources (DRG, ICD and CPT) and Medical Information/Medical Management Systems is required. Knowledge of Medicaid, community resources, alternate funding programs, Texas Health and Human Services Commission and Texas Department of Insurance HMO standards and NCQA in a managed care setting is required. Supervisory experience is preferred. LICENSURE/CERTIFICATION Clinicians serving as a supervisor must hold/maintain current licensure requirements in his/her specialty with the State of Texas. All staff serving as a supervisor must maintain a current certification from an appropriate professional agency (such as Case Management Society, Six Sigma, Project Management, etc.) or must be obtained within 24 months of accepting the position.