Job: Nurse Manager

Jobing Description

APS Healthcare is a leading provider of specialty healthcare solutions to more than 20 million members in the United States and Puerto Rico. Our team has a drive for excellence and we are committed to a common goal in which we all deeply believe: changing healthcare for the good of the clients we serve, their members and the local communities in which we work.

The Bureau for Medical Services (BMS) has retained APS-WV to provide administrative services for the implementation and oversight of the Traumatic Brain Injury (TBI) Waiver. The functions for the program include, but are not limited to, provider certification, member enrollment, service authorizations, program eligibility determinations, member assessments, member education, provider training, data analysis/reporting, and CMS QI System implementation. Through this program persons with TBI can receive services and supports to enable them to live in community settings.

The Nurse Manager provides direction and oversight for the TBI Waiver ASO to ensure achievement of service deliverables related to utilization management, provider education, customer service, data analysis, training and consultation to providers and contractors. The Nurse Manager provides on going supervision to the team, coordinates inter-rater reliability functions and establishes team policies and procedures. The Nurse Manager provides assistance with RFP related activities and other implementation. The Nurse Manager meets on a scheduled basis with TBI BMS Contract Manager.

Education:
Bachelors Degree in Nursing preferred
Must possess an active WV RN license and be in good standing with licensure board

Requirements:
Minimum of 2-3 years experience related to area of contract; one year of service related to area of contract preferred
Prior leadership and supervisory experience required
Experience with Public Sector programs/administration a plus
Possess knowledge of conditions and best practices related to population groups
Basic knowledge of APS-WV programs
Maintain confidentiality standards and HIPAA compliance when evaluating all pertinent issues
Able to organize and prioritize tasks to meet deliverables
Effective communication skills and professional interactions with others
Flexibility in responding to business/contractual needs.
Ability to utilize Microsoft software (i.e., Outlook, Word, and Excel) and web applications
Ability to integrate knowledge, best practices and research to formulate decisions
Ability to integrate information related to other APS WV programs and performs applicable functions when necessary
Establish and update protocols, guidelines and other resources for maximum applicability