Clinical Care Management (CCM) Manager (Registered Nurse)

Key Responsibilities 

• Team Leadership: Supervise, train, and schedule the Care Coordinators and Case Managers handling telephonic patient assessments, care plan development, and facility triage.  

• Quality & Escalation: Serve as the first point of escalation for complex patient care plans or high-risk clinical triage decisions. 

• Workflow Optimization: Monitor triage queue metrics, response times, and document auditing within the electronic medical records (EMR) system. 

• Liaison Work: Collaborate directly with upper executive management and the practicing Physicians/NPs to adjust clinical protocols as regional needs shift. 

 
1. Patient and Caregiver Support 

• Review electronic health records (EHR) to identify gaps in care for patients residing in a Long-term Care Nursing Facility. 

• Review and approve initial and ongoing health questionnaires completed by a member of the care management team. 

• Develop patient-centered care plans. 

• Educate patients and their durable medical power of attorney (DPOA) on the benefits of CCM. 

2. Provider Support 

• Support quality gap closure through clinical discovery 

• Schedule Provider visits for at-risk patients 

• Coordinate with the Transitional Care Manager to schedule patient visits  

• Ensure orders, referrals, and prior authorizations are facilitated by the virtual care support team. 

• Escalate abnormal diagnostic test results to providers. 

3. Communication Support 

• Communicate patient health updates to providers. 

• Communicate treatment plans and health updates to the patient’s caregiver in an effective and caring manner. 

• Primary liaison between the provider, facility and administrative support team. 

Job Requirement: 

• Must hold an active and unrestricted compact Registered Nurse (RN) License and be able to obtain additional state licenses, as needed. 

• Minimum of 5 years of experience as a Registered Nursing in inpatient, outpatient, or skilled nursing facilities settings. 

• Minimum of 2 years of Case Management experience 

• Certified Care Manager (CMC) or Chronic Care Professional (CCP) certification 

• Proficiency with various Electronic Health Records