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Nascentia Health
The Supervisor of MAP Care Management and LTSS provides direct leadership to care management staff, oversees utilization management and transitions of care, and is accountable for performance related to CMS Star Ratings, HEDIS measures, and internal quality benchmarks. This role partners closely with the Quality, Compliance, Medical Management, Utilization Management, and Analytics teams to ensure audit readiness, accurate reporting, and continuous performance improvement.
Performance Responsibilities and Standards:
Qualifications:
1. Nursing: License and current registration as a Registered Professional Nurse in New York State. Education: Bachelors degree in nursing, healthcare administration, or related field preferred; Associates Degree in Nursing required
2. Valid New York State driver’s license. Hybrid role: Primarily home-based with occasional in-office or on-site meetings.
3. Minimum of 5 years of RN experience in managed care, Medicare Advantage, long-term services and supports, or related settings. Clinical expertise in chronic disease management preferred.
4. At least 2–3 years of management or supervisory experience in care management or utilization management. Strong leadership, coaching, and staff development skills.
5. Demonstrated experience with CMS regulations, Medicare Advantage requirements, and LSSS populations. In-depth knowledge of CMS Medicare Advantage, MOC, and managed care regulations
6. Case Management Certification Preferred
7. Experience supporting Stars, HEDIS, and quality performance initiatives preferred.
Physical Requirements:
1. Standing, sitting, bending, walking, and driving (frequently entering and exiting vehicle throughout the day) are standard postures.
2. Frequently uses a laptop computer to enter orders and obtain product information.
3. Sensory requirements include speech, vision, smell, and hearing.
4. Lifting requirements of up to 20 pounds frequently and up to 50 pounds occasionally
5. Bloodborne Pathogens Exposure Category I - Employee has tasks that routinely involve exposure or potential exposure to blood, body fluids or tissues.
Compensation & Benefits:
Competitive Salary [This position is an S06 exempt position with a min-max rate of: $99,000- $114,000 /annually] with:
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About Nascentia Health:
Nascentia Health is leading the way in home care, post acute care and long-term community health. A healthcare system without walls, Nascentia is an innovator in the concept of healthcare, truly focused on the patient as a whole. By serving people in their homes, Nascentia Health is able to provide true holistic care. We can address immediate needs, help support positive long term medical and lifestyle choices that provide for better outcomes, leverage cutting edge in-home care technologies, and help avoid unnecessary visits to busy healthcare facilities.
Our employees are our greatest asset. They work hard every day to make our system amazing and are dedicated to our mission of being the premier home and community-based care system for the regions we serve. We want everyone to love what they do, be excited about coming to work, and take pride in being part of our team.
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Nascentia Health is an Equal Opportunity Employer (EOE)
Employment is contingent upon negative results of a pre-hire drug screen and background check clearance