Landmark Health Supervisor, Clinical Nurse in Slidell, Louisiana
Do you want to make a difference in healthcare?
Landmark Health was created to transform how healthcare is delivered to the most medically vulnerable members in our community. Our medical group provides home-based medical care to chronically ill patients, many of whom are frail, elderly and ill-equipped to navigate our overwhelming healthcare system.
Because many of our patients are frail and elderly, we deliver care primarily in the comfort of their home. Our Program is also offered to eligible patients at no incremental financial cost to them. We are not a fee-for-service practice; we benefit economically only if we deliver high-quality patient outcomes and satisfaction. As a result, our clinical teams can spend quality-time caring for a smaller number of patients, giving all patients the space, respect, compassion and care they deserve.
Our model is finding success throughout the country; we are now the nation’s largest risk-based, in-home medical group, with operations in six markets and four states across the country.
At Landmark, our interdisciplinary teams collaboratively manage our complex patient panels. These teams are led by Physicians, Nurse Practitioners, and Physician Assistants, with supporting care provided by RN Nurse Care Managers, Social Workers, Pharmacists, Behavioral Health and other employed team members.
The Clinical Nurse Supervisor is responsible, as part of the Market Leadership and care teams, for the overall patient Care Management process. The position reports to the Health Services Director and provides oversight, guidance and support for the processes related to the development, implementation and outcomes of member care plan as developed through clinician, CM and allied clinical support evaluation and physical risk assessment. The position provides support for the day to day operations including scheduling, outreach, and assignments. Working with the Health Services Director, their role would be to be the main contact for health plan referrals, inpatient notifications, interdisciplinary team and care coordination. The position is a system super user and is involved with training and oversight of the new hires and ongoing staff. The Clinical Nurse Supervisor, as part of the leadership team, facilitates relationships in the community with providers, health plans, vendors, facilities and community organizations.
Provide operational support for the Health Services Director and Market Leadership team
Interface/collaborate with contracted health plan contacts on patients referred to Landmark programs.
Assist with strategy and process development, and implementation, including measurement of outcomes
Verify eligibility for Landmark program referrals, community referrals as well as internal referrals through review of cohort lists and collaboration with health plan contacts
Outreach and follow cohort patients admitted to hospitals for admission to Landmark programs and facilitate post discharge follow-up
Discuss with patient, family and extended decision makers the benefits of participation with Landmark programs post hospitalization
Open case management cases in Essette for case management referrals; and assigns cases to NCMS and providers based on assigned territory
Attend and actively participate in contracted health plan IDT, Clinical Operations, JOC’s and other operational meetings as required
Act as super-user and trainer for Essette, and CRM and other systems
Working with the corporate Operations team, assures documentation is completed by providers and reported up to HSD
Visit patients in hospital/SAR who are not yet enrolled and those that are to assure a smooth transition home
Monitor Daily Pulse Report and other performance and operational reporting to take appropriate action based on the data
Schedule Urgent visits for providers from on-call and during business hours, including juggling the schedules
Triage phone calls that come into office to ensure appropriate disposition and action
Triage and take appropriate action regarding warm transfer calls from Outreach
Maintain health plan referral Logs
Maintain patient Hospitalized/SAR log book and/or electronic tracking systems
Maintain weekly IDT Stat Sheet, minutes, sign in sheets and log book
Lead weekly IDT meetings
Email daily the list of new patients to provider and NCM
Actively involved with training of new NCMs and Providers
Support and execute corporate initiatives
Reconcile provider’s schedules and make appropriate corrections
Open new cases in Essette for NCMs
Meet with families in facilities and at home as needed to discuss Landmark programs
Represent Landmark at provider, vendor, facility and health plan meetings as assigned/requested
Collaborate with Office Manager for provider and NCM medical supply needs
Oversee the CMA process for scheduling of maintenance visits using the maintenance tracker report
Maintain staff PTO calendar
Maintain On call schedules/calendars for Providers and NCM's
Collaborate with SAR/ALF facilities for appointment dates for post discharge and updates for those already enrolled.
Maintain Provider schedules for meetings, PTO etc.
Maintain quality of services through audits and education
Participate in and lead CQI teams
Serve as a resource to the entire care delivery team
Identification, tracking, resolving, responding to and reporting any quality of care issues
Maintain HIPAA compliance as it relates to member care
Participate in interviewing, hiring training, evaluating and disciplining of IDT staff
Other duties as assigned
Current RN License, BSN preferred
5+ years of clinical practice in a hospital, clinic, home care, or nursing home setting
2-3 years of increasing supervisory or management experience in a health care setting
Case management experience required
Disease and utilization management experience useful
Physician office experience helpful
Job ID: 2018-1915
External Company URL: landmarkhealth.org