RN Care Delivery Manager

We are seeking an experienced Care Delivery Manager (RN) with a strong background in Managed Long Term Care (MLTC), community health, and home care services. This leadership role is responsible for overseeing care management operations, supporting nursing standards of excellence, and ensuring the delivery of high-quality, patient-centered care to members throughout the continuum of care.

The ideal candidate will possess a combination of clinical expertise, leadership ability, care coordination experience, and a deep understanding of MLTC regulations and best practices. This individual will provide supervision, coaching, and professional development to nursing and care management staff while driving quality outcomes and member satisfaction.

Key Responsibilities

• Oversee the daily operations of the Care Management team, ensuring high-quality service delivery and compliance with organizational standards.
• Supervise, mentor, and support nurses and care management staff through coaching, performance management, and professional development.
• Ensure comprehensive member assessments, care plan development, and ongoing care coordination are conducted in accordance with MLTC requirements.
• Monitor clinical outcomes, quality measures, and member satisfaction to identify opportunities for process improvement and enhanced care delivery.
• Collaborate with interdisciplinary teams, physicians, community providers, and external agencies to coordinate member services and achieve optimal outcomes.
• Review complex clinical cases and provide guidance regarding care planning, utilization management, and service authorization.
• Ensure compliance with federal, state, MLTC, Medicare, Medicaid, and organizational regulations and policies.
• Promote best practices in community health, chronic disease management, transitional care, and population health initiatives.
• Participate in quality improvement projects, audits, and regulatory preparedness activities.
• Facilitate staff education and ongoing training to maintain clinical excellence and regulatory compliance.
• Analyze performance metrics and develop action plans to improve operational and clinical outcomes.

Qualifications

Required

• Active New York State Registered Nurse (RN) License.
• Bachelor's Degree in Nursing (BSN) required.
• Minimum of 5 years of nursing experience.
• Minimum of 2-3 years of supervisory or management experience.
• Previous Managed Long Term Care (MLTC) experience required.
• Strong community health, home care, care management, or case management background.
• Experience conducting clinical assessments and developing individualized care plans.
• Knowledge of Medicare, Medicaid, MLTC regulations, and care management best practices.
• Excellent leadership, organizational, communication, and interpersonal skills.
• Proficiency with electronic medical records and care management systems.

Preferred

• Master's Degree in Nursing, Healthcare Administration, Public Health, or related field.
• Certified Case Manager (CCM) or related certification.
• Experience managing interdisciplinary care teams.
• Quality improvement and utilization management experience.