Duke Connected Care, a community-based, physician-led network, includes a group of doctors, hospitals and other healthcare providers who work together to deliver high-quality care to Medicare Fee-for-Service patients in Durham and itssurrounding areas.
The Manager serves in the Population Health Management Office (PHMO), and works in collaboration with leadership and key stakeholders to advance Duke Health's strategies to align systems of care and enhance patient experience.
The Manager focuses on improving care transitions across the continuum, and implementing and evaluating the Age Friendly initiative across the health system.
The Manager engages with other leaders, stakeholders, and teams including PHMO/DCC, inpatient case management, the Executive Steering Committee of the Geriatrics Coordinating Council (GCC) and its members.
This position must work effectively with diverse groups/leadership, and must foster collaboration and partnerships to accelerate improvement and identify and address opportunities.
Scope of Responsibility:
In addition to key initiatives defined by PHMO leadership and other key stakeholders, the Manager provides operational oversight to:
the delivery of care transition services across the care continuum provided by PHMO, and in collaboration with key team members across the health system to align systems and functions of care coordination.
the development and implementation of Duke Health's Geriatric Operational Plan (GOP), which includes supporting strategic development and operational alignment with the GCC and PHMO/DCC initiatives, development of an Age-Friendly Health System (AFHS), coordination between inpatient, post-acute, and ambulatory care settings, and coordination and care management with providers and community-based initiatives.
Duties and Responsibilities:
Oversees daily clinical operations led by the Resource Center Team Leads.
In conjunction with the Resource Team Leads, this Manager will assess team member workload and keeps ACNO and other PHMO leadership informed of workflow or personnel concerns.
Able to provide hands-on support for critical staffing and program needs.
Electronically documents, reviews, and monitors activity in Maestro and other documentation systems relevant to the position and the programs, to understand and recommend appropriate system changes.
Establishes necessary PHMO team performance improvement for age-friendly activities including monitoring progress, measuring results, completing market and performance analysis, maintaining context with clinical issues and evidence-based practice.
Participates in Resource Center team member supervisory functions in collaboration with the team lead and ACNO to include:
conducts team member 30-60-90 day and mid-year and end-of-year evaluations
ensures team member compliance with licensure and certification requirements of new and existing employees in collaboration with PHMO HR Manager
recruitment, hiring, onboarding, and retention activities
Evaluates clinical practice of specified discipline and review clinical records to ensure standards of care and quality of services are provided in accordance with DUHS expectations.
Facilitates the development and dissemination of the Duke Age Friendly Initiative across Duke University Health System in collaboration with leadership identifies, plans, and executes activities to promote this program.
Collaborate with Performance Services on data analytics and reports to monitor progress and outcomes in Key Performance Areas for the Geriatrics Operational Plan (i.e., scorecard and tableau)
Collaborates with Duke Center for Geriatric Nursing Excellence (CGNE) in advancing Interprofessional Age Friendly education for all team members.
Facilitates internal and external communication regarding an Age Friendly Health System including development of a relevant website (e.g., Sharepoint).
Education: Work requires a bachelor's degree in a clinical field such as Nursing, Counseling, or Social Work. A master's degree is strongly preferred.
Experience: Work requires a minimum of five years of clinical experience, including supervisory and program development experience OR any other equivalent combination of relevant education and/or experience.
Degrees, Licensure, and/or Certification:
Must have a current license in at least one of these areas: current or compact RN licensure in the state of North Carolina, current licensure as a licensed clinical social worker by the NC Social Work Certification and Licensure Board, current licensure as a licensed professional counselor by the state of NC, or current licensure as a licensed addiction specialist by the state of North Carolina.
Requires ACM or CCM certification within 3 years of hire date.
Knowledge, Skills, and Abilities:
Exceptional verbal/written communication and facilitation skills
Job Code: 00005593 MGR, POPULATION HEALTH CARE MGMT Job Level: G2
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