Clinical Operations Lead - RN Care Manager

Montefiore · $125,000 (stated in the posting)

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Job Summary

The Clinical Operations Lead – Case Management is an advanced practice Registered Nurse responsible for coordinating patient care progression, discharge planning while exercising independent clinical and operational judgment. This role functions as a designated lead for assigned unit(s) and is accountable for driving patient throughput, reducing length of stay, and ensuring timely, safe transitions of care. In addition to direct patient care coordination responsibilities, the Case Management Lead serves as a Queue Owner for assigned Case Management Assistant (CMA) workstreams. The role provides functional oversight of CMA workflow through real-time prioritization, assignment, and redistribution of tasks based on clinical acuity, discharge urgency, and patient readiness for discharge. The Case Management Lead ensures that time-sensitive activities such as authorizations, transportation arrangements, and post-acute coordination are executed efficiently to support patient flow and prevent discharge delays. The Case Management Lead monitors CMA task completion, quality, and adherence to workflow standards, providing ongoing feedback and contributing structured input into performance evaluations based on observed work output. The role is accountable for the effective operation of assigned work queues, including timely resolution of barriers and alignment of task prioritization with clinical milestones. This position collaborates closely with physicians, nursing, and interdisciplinary teams, leading or co-leading discussions related to care progression and discharge readiness. The Case Management Lead exercises independent judgment to resolve complex patient flow challenges and escalates system-level barriers as needed. This role also participates in structured hiring panel processes for Case Management staff and contributes to the development and optimization of workflow systems and operational processes.


Essential Functions

• C. Job Specific Contacts
  
  The Clinical Operations Lead maintains regular interaction with a broad range of internal and external stakeholders to coordinate patient care, facilitate discharge planning, and ensure efficient workflow execution.
  
  General Contacts: (Internal)
  • Physicians and Advanced Practice Providers (APPs)
  • Nursing staff (unit-based RNs, charge nurses, leadership)
  • Case Management team members
  • Case Management Assistants (CMAs) – for workflow direction, task prioritization, and performance feedback
  • Social Work / Care Coordination staff
  • Utilization Review staff
  • Finance / Revenue Cycle (as needed for authorization or coverage issues)
  • Quality and Performance Improvement teams
  • Hospital leadership and department management
  
  (External)
  • Post-acute care providers (Skilled Nursing Facilities, Acute Rehab, Long-Term Care)
  • Home care and hospice agencies
  • Durable Medical Equipment (DME) providers
  • Transportation vendors
  • Insurance companies / payers for authorization and coordination of services
  • Patients and families / caregivers
  
  Financial & Throughput Accountability
  • Actively manages patient throughput by monitoring and influencing geometric mean length of stay (GMLOS) and actual length of stay (LOS) to ensure alignment with clinical benchmarks and organizational targets
  • Identifies and addresses avoidable days and delays in discharge through proactive care coordination and workflow optimization
  • Utilizes clinical judgment and operational oversight of CMA workflow to prioritize tasks that directly impact discharge readiness and reduce excess days
  • Collaborates with physicians, utilization review, and revenue cycle teams to ensure appropriate level of care determinations and timely progression of care
  • Contributes to hospital financial performance by reducing unnecessary utilization, preventing delays, and supporting efficient resource use across the continuum of care
  
  2. Job Provides Direction to: CMA (Case Management Assistants)
  
  
  D. Environment and Demands
  
  1. Environmental Demands: This position is performed primarily in a healthcare setting and requires the ability to function effectively in a fast-paced, high-acuity hospital environment.
  
  2. Essential Physical and Cognitive Demands, Manual Dexterity:
  Primarily sedentary work with prolonged periods of sitting, computer use, and documentation. Frequent standing, walking between units, and attending interdisciplinary rounds. Occasional lifting of light objects (e.g., charts, laptops) up to 10–15 pounds. Visual acuity required for reviewing electronic medical records and documentation.
  Must follow all hospital safety protocols, including infection control, HIPAA compliance, and patient confidentiality standards. Use of appropriate personal protective equipment (PPE) when required. Extensive use of electronic medical record systems (e.g., Epic) and workflow management tools. Ability to navigate multiple systems simultaneously for documentation, communication, and task management. High level of concentration and attention to detail required for clinical decision-making and workflow prioritization. Ability to manage multiple tasks simultaneously in a high-pressure environment. Frequent need for critical thinking, problem-solving, and independent judgment. Rapid prioritization based on changing patient acuity, discharge status, and workflow demands.
  
  B. MISSION/STRATEGIC PLAN:
  
  Demonstrates support of the mission and strategic action plan through the initiation and ongoing implementation/ evaluation of department activities/plans.
  
  
  C. JOB SPECIFIC COMPETENCIES:
  
  Demonstrates the technical/professional knowledge, skills and abilities necessary for the successful operations of the department including, where applicable, age specific competency. *
  
  1. Drives patient progression and discharge efficiency through proactive management of clinical milestones and system barriers.
  
  2. Exercises authority over CMA workflow through prioritization, task allocation, and real-time redistribution aligned with clinical needs. Monitors CMA work output and provides structured, data-informed input into performance evaluations based on direct workflow oversight.
  
  3. Utilizes data and performance metrics to drive decision-making, improve processes, and achieve departmental goals.
  
  4. Leads and helps facilitate collaboration across disciplines to ensure efficient care progression and alignment with discharge goals.
  
  * Document on addendum age specific competency.
  
  Part II: Employee Performance Standards
  
  A. CUSTOMER SERVICE:
  
  1. Demonstrates personal excellence in customer service for both internal and external customers.
  
  2. Holds CMA staff accountable for the delivery of excellent customer service.
  
  3. Participates in team efforts to increase the level of customer satisfaction.
• B. PERFORMANCE IMPROVEMENT:
  
  1. Demonstrates the ability to recognize an opportunity for improvement and to collect and assess data.
  
  2. Demonstrates the ability to develop, implement and evaluate a Performance Improvement Plan.
  
  3. Participates in Departmental/Hospital-wide activities which improve processes/outcomes.
  
  4. Utilizes resources to maintain and improve self knowledge and development and fosters the same for employees.
  
  5. Demonstrates compliance with licensure/certification requirements and the timeliness of their submission.
  
  D. PROJECTS/ASSIGNMENTS:
  
  1. Completes projects/assignments within projected time frames and expectations.

Qualifications

• BS Bachelor of Science in Nursing (BSN) required
• MA Master’s degree in nursing, Healthcare Administration, or related field preferred
• Minimum of 3–5 years of acute care clinical nursing experience required. Minimum of 2–3 years of Case Management, Care Coordination experience required. Demonstrated experience in discharge planning, transitions of care, and interdisciplinary collaboration. Experience working with post-acute care networks, including SNF, rehab, and home care preferred. Prior experience in a lead role, charge role, or functional oversight capacity preferred.
• Discharge planning standards and transitions of care best practices. Experience with electronic medical records (e.g., Epic Systems) and work queue/task management systems
• Demonstrated ability to exercise independent clinical and operational judgment. Strong critical thinking and problem-solving skills in complex patient flow situations. Ability to prioritize and manage multiple competing demands in a fast-paced environment. Effective communication and collaboration with interdisciplinary teams, including physicians and ancillary staff. Ability to influence workflow and drive outcomes without formal supervisory authority. Strong organizational skills and attention to detail
• Ability to direct and prioritize workflow for support staff (e.g., CMAs). Experience monitoring work quality, timeliness, and adherence to process standards. Ability to provide constructive feedback and contribute to performance evaluations. Demonstrated accountability for operational outcomes (e.g., LOS, discharge delays, throughput)
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