Celebrating Lives and Healing SpiritsWorking at ArchCare is an opportunity to give back to your community in a compassionate and nurturing environment.

You will enjoy a competitive salary and the satisfaction of making a difference in someones life.

Works with Director to recruit nurse practitioners.

Develops and provides orientation to new nurse practitioners and routine training including operational policies and procedures, workflows, internet resources to existing nurse practitioner staff.

Manage and develop nurse practitioner staff by setting goals and providing daily feedback, re-direction and coaching.

Serves as a resource to support high-quality Model of Care, member advocacy, provider education, nursing home in-service, benefit determinations and utilization analysis.

Conducts monthly team meetings with all NPs that include agenda and minutes to share program results including quality and utilization metrics, Develop and facilitate collaborative relationships with other members of the health services team, as well as the broader site staff, to serve on committees, develop best practices, and facilitate communication and to guide the relationship of the Care Manager and the NPs.

Ensures NP compliance w ArchCare policies & procedures including authorization processes and super-bills.

1. Evaluates the activities of NP staff to audit and improve performance: · Coordinates and reviews with the Manager of Quality Management, all routine quality audits, all incidents and grievances and individual cases, including sentinel events, to ensure that process standards are met, educational opportunities are addressed, and successful outcomes are achieved.

· Review cases daily with NP team members to verify that care planning efforts are focused and prioritized.

· Based on this daily review of cases, communicates with the Medical Director, on a daily basis, about all potential hospitalizations, actual hospitalizations, potential transfers to nursing homes and actual transfers to nursing homes from hospitals.

· Evaluates the consistency, thoroughness, quality and compliance of processes documented in the clinical medical record (computer system).

· Ensures that the clinical teams policies and procedures, including internal controls, are in compliance with ArchCare Advantage and Government program standards.

3. Provides business analysis of health care services for trending and tracking of medical expenses that support utilization management initiatives at the site.

· Performs root cause analysis and identifies aberrant benefit, service deliver or finance trends in conjunction with other members of site staff.

· Tracks and analyzes information to identify barriers to effective Care Coordination including transfers to and from hospital.

· Develops, in conjunction with other staff and the Medical Director, action plans to manage utilization which appropriately use personnel and resources to increase access to medically necessary services, decrease access to medically unnecessary services, decrease re-hospitalizations when appropriate, enhance transitional care, and achieve business goals.

· Monitors progress of action plans to achieve consistency, resolve problems and/or meet business goals.

· Communicates with staff and providers to develop appropriate high quality, cost effective, alternative care and services for members.

· Educates and orients key providers regarding Model of Care and Care Planning processes, benefit review processes.

· Identifies compliance issues that may affect the organization and develops action and implementation plans to address them.

Position requires 3-5 years supervisory management experience, with a managed care or insurance company.

Current NP license, preferably Geriatric NP. To begin making a difference, apply on-line at: www.archcare.

org/careers.html.

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