PHM Special Programs Supervisor RN

Kern Family Health Care, 2900 Buck Owens Blvd., Bakersfield, California, United States of America Req #1773
Wednesday, June 29, 2022
We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications.  A clear understanding of your background and work history will help us potentially place you in a position that meets your objectives and those of the organization.  Qualified applicants are considered for positions without regard to race, color, religion, sex (including pregnancy, childbirth and breastfeeding, or any related medical conditions), national origin, ancestry, age, marital or veteran status, sexual orientation, gender identity, genetic information, gender expression, military status, or the presence of a non-job related medical condition or disability (mental or physical).


Our Mission.. Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system.

Primary Purpose

Under direction of the Kern Health Systems (KHS) Director of Population Health Management, the Special programs Supervisor is responsible for provision and oversight of management of KHS members in special PHM programs. KHS Special programs are developed for special populations identified thru evidence-based risk stratification process or mandated by DHCS. The programs are either managed internally by KHS staff or managed externally by community partners. The goal of these programs is to provide whole person care to specific identified population and ensure improvement in health of the individual member. 

Primary Purpose

Under direction of the Kern Health Systems (KHS) Director of Population Health Management, the Special programs Supervisor is responsible for provision and oversight of management of KHS members in special PHM programs. KHS Special programs are developed for special populations identified thru evidence-based risk stratification process or mandated by DHCS. The programs are either managed internally by KHS staff or managed externally by community partners. The goal of these programs is to provide whole person care to specific identified population and ensure improvement in health of the individual member. 

The Special programs Supervisor employs a variety of strategies, approaches, and techniques to ensure that the coordinating member's physical, environmental, and psycho-social health issues are addresses in a culturally sensitive way. The Special programs Supervisor ensures each patient is progressing towards desired outcomes by continuously monitoring care provided in the programs through review and analysis of different reports, metrics and/or evaluations 

The Special programs Supervisor employs a variety of strategies, approaches, and techniques to ensure that member's physical, environmental, and psycho-social health issues are addresses in a culturally sensitive way. The Special programs Supervisor ensures each patient is progressing towards desired outcomes by continuously monitoring care provided in the programs through review and analysis of different reports, metrics and/or evaluations 

Distinguishing Characteristics

The Special programs Supervisor’s work assignments are varied and frequently require direct communication with KHS staff, providers, interpretation, and independent determination of the appropriate courses of action.

Supervises: Yes

Essential Functions

Provide network education & clinical support;

Serve as the provider single point of contact for all program services;

Provide clinical support to non-clinical departments in the development of training for internal and  external strategic partners to ensure successful Population health programs;

Develops/updates policies and procedures to ensures compliance with state and NCQA standards for population health and special programs;

Manages, coaches, mentors and develops staff;

Organizes and leads ICT and facilitate care coordination and notification to providers;

Serve as the KHS program content expert (SME) with review and update HS department on changes in requirements and processes related to the Special programs;

Core Competencies/Knowledge & Skill Requirement

Lead by example to support a positive work environment that values patient advocacy, respectful listening, diverse expression of opinion and constructive conflict resolution; 

Adheres to KHS’s Code of Ethics and Business Conduct and all company policies, e.g., confidentiality, attendance, safety/security, use of equipment and technology, appearance, and demeanor; 

Represent KHS in a positive manner to all members, caregivers, staff and external stakeholders; 

Demonstrate commitment to continuous improvement; 

Strong knowledge of acute chronic care nursing principles, methods and common treatments; 

Strong knowledge of common human diseases and usual and customary methods of treatments; 

Demonstrated knowledge of health care delivery systems; 

Very strong interpersonal skills, including the ability to establish and maintain effective working    relationships with individual at all levels both inside and outside of KHS; 

Ability to use tact and diplomacy to diffuse emotional situations;

Effective oral and written communication skills, including the ability to effectively explain complex information and document according to standards; 

Intermediate skills in Word and Excel with basic ability to enter data into and navigate through a database; 

Demonstrated ability to respect and maintain the confidentiality of all sensitive documents, records, discussions, and other information generated in connection with activities conducted in, or related to, patient healthcare, KHS business or employee information and make no disclosure of such information except as required in the conduct of business; 

Demonstrated ability to commit to and facilitate an atmosphere of collaboration and teamwork; 

Self-directed, with proven ability to work independently with minimum supervision; 

Demonstrated ability to multi-task in an interrupt-driven environment and complete assignments on a timely basis; 

Strong attention to detail; work accurately and at a reasonable rate of speed; 

Compliant with KHS policies and procedures; performs the job safely and with respect to others, to property, and to individual safety;

Monitors and evaluates the effectiveness of the programs and develop corrective active plans for the program as indicated;  

Develops collaborative action plans with clearly identified, achievable objectives, focused on modifiable risk factors;

Recognize members’ right to participate or refuse treatment;

Participates in and facilitates, as needed, care management conferences with members, providers, and other specialist and/or ancillary providers;

Communicate, consult, and collaborate with KHS Chief Medical Officer and/or Medical Director on an as needed basis;

Serve as a liaison to community providers and KHS; 

Collaborate with KHS staff to facilitate production of reporting necessary to obtain statistics to monitor, and oversight the effectiveness of the Special programs; 

Provide written and verbal communication with contract providers and KHS staff to promote appropriate and timely coordination of care;

Perform other related duties and special projects as assigned;

EMPLOYMENT STANDARDS:

Education:

Possession of active California Registered Nurse (RN) License;

Bachelor’s Degree from an accredited institution in Nursing, Health Administration, or related healthcare field required;

Certified Case Manager (CCM) preferred;

Experience:

Minimum of five (5) or more years of clinical nursing experience working with patients and caregivers regarding self-care and disease management required; AND

Two (2) or more years of experience as an RN in an acute hospital setting required;

Minimum two (2) years in supervisory role with direct reports required;

Experience in building collaborative relationships preferred;

Experience working in health care delivery systems and/or in a public agency/ organization serving Medi-Cal and/or Medicare populations is preferred;

Knowledge of:

Managed care health plan, case management or care coordination experience is a plus;

Knowledge of MCG Evidence based criteria; 

Proficient with various health information systems/electronic medical record navigation; Microsoft Office Suite including Visio;

Other:

Possession of valid California Driver’s License and proof of valid State required auto liability; insurance. Required travel up to 10%; 

Bilingual (English/Spanish) preferred; 

We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis.

Other details

  • Pay Type Salary
  • Travel Required Yes
  • Travel % 10
  • Telecommute % 0
  • Required Education Bachelor’s Degree
Location on Google Maps
  • Kern Family Health Care, 2900 Buck Owens Blvd., Bakersfield, California, United States of America