Nurse Manager of Clinical Support Services

2339

Remote?: 1

Highlights (Bonus, shift, relocation, info for job):

Job Summary

 

The Nurse Manager of Clinical Support Services (NMCSS) is responsible for overseeing the daily operations and performance of the nurse triage Line of our centralized Member Access Center (MAC), the Diagnostic Imaging (DI), and Durable Medical Equipment (DME) Coordination teams.  This role is a registered nurse who directs patients through the healthcare system, especially those facing complex or serious diagnoses. They act as guides and advocates, helping patients understand their options, access resources, and overcome barriers to care.  This role ensures that care coordination processes are executed efficiently and in compliance with clinical and administrative standards.  They also manage an inbound nurse call line that triages clinical issues and concerns telephonically.  The Nurse Manager provides leadership, training, and support to staff, monitors workflow, and collaborates with internal and external stakeholders to optimize patient care and service delivery.  This role will serve as a primary point of contact for any clinical questions that arise through the processing of specialty referrals, diagnostic imaging, and durable medical equipment.

 

Duties and Responsibilities

 

CLINICAL SUPPORT SERVICES:

• The Nurse Manager of Clinical Support Services is responsible for leading and managing the inbound clinical contact line of the MAC, ensuring timely, accurate, and compassionate triage and troubleshooting for all incoming patient concerns. The inbound contact line is directly from patients and from non-clinical staff members where clinical concerns arise with patients.
• This role oversees a team of licensed nurses and support staff who serve as the first point of clinical contact for patients, providing guidance, care coordination, and escalation as needed.
• Supervise day-to-day operations of the inbound nurse triage line, ensuring coverage, quality, and compliance with clinical protocols.
• Serve as the clinical escalation point for complex or high-risk calls for our community patients.
• Ensure all calls are triaged according to established clinical guidelines and urgency levels.
• Oversee the use of triage software and documentation standards to ensure consistency and accuracy.
• Monitor call disposition outcomes (e.g., ED referral, ICA visit, phone management) and ensure alignment with clinical goals
• Conduct regular audits of triage documentation and call handling.
• Identify trends in call types and outcomes to inform training and workflow improvements.
• Partner with care coordination, behavioral health, and community health teams to ensure seamless handoffs and follow-up.

 

DIAGNOSTIC IMAGING SCHEDULING:

• Supervise and support the DI and DME Coordination team in their daily responsibilities (approximately 7 FTEs).
• Ensure compliance with scheduling protocols and documentation standards.
• Monitor team performance metrics and implement quality improvement initiatives.
• Schedule various DI procedures, including X-rays, CT scans, MRIs, ultrasounds, and other related tests, based on physician orders.
• Oversee the verification of patient insurance information and obtain necessary pre-authorizations.
• Be available to peer-to-peer reviews needed for approval of DI.
• Oversee communication with patients to provide pre-procedure instructions and address any questions or concerns.
• Communicate transportation needs to internal facilitators.
• Monitor and troubleshoot changes in provider assignments that could invalidate existing referrals.
• Monitor DI through the lifecycle of an order to ensure it is completed and the result comes back through the electronic health record system to a provider to close out the order.
• Supervise communication with the care team of any barriers to completion of the order such as when patients refuse appointments, or no show more than once with scheduling facility for DI.
• Develop partnerships with outside vendors for DI and DME processing to decrease barriers to care, increase efficiency, and improve patient satisfaction

 

DURABLE MEDICAL EQUIPMENT PROCESSING:

• Supervise and support the processing and management of DME requests from providers, ensuring accuracy and completeness.
• Oversee the verification of patient insurance coverage and obtain necessary pre-authorizations for DME.
• Assist with the generation of “Letters of Medical Necessity” templates needed for approval of durable medical equipment.
• Monitor diagnostic imaging and DME through the lifecycle of an order
• Oversee communication with DME vendors to place orders and track delivery status.
• Ensure the maintenance of accurate records of DME orders and deliveries.
• Continually explore best practices and innovative practices for time efficient processing of DME.

 

GENERAL DUTIES:

• Oversee and grow a new and rapidly expanding department of clinical support services.
• Lead onboarding and ongoing training for all direct reports (initially 7 FTEs).
• Provide coaching, mentorship, and performance evaluations for all direct reports.
• Maintain up-to-date training materials and ensure staff are informed of policy changes.
• Participate in the development and implementation of policies and procedures.
• Provide excellent customer service to all patients, ensuring they have appropriate and necessary information and instructions.
• Resolve escalated issues by serving as the clinical subject matter expert for any clinical questions generated by ongoing external specialty referrals, diagnostic imaging processing or durable medical equipment processing.
• Collaborate with Market Leadership and Shared Service to continually improve and streamline processes.
• Collaborate with leadership to align departmental goals with organizational objectives.
• Participate in interdisciplinary meetings and contribute to strategic planning for clinical access and patient engagement.
• Responsible for ensuring appropriate coverage for all departmental staff.

 

Minimum Qualifications

 

• Registered Nurse (RN) license required. Compact Nurse licensure and licensing in any state that AbsoluteCare has a market in, who do not allow compact licensure, must be obtained within 30 days of employment initiation. 
• Minimum of 5 years of clinical experience and 5 years of experience in a supervisory or leadership role.
• Minimum of 3 years of clinical experience in telephonic triage of complex patients.
• Minimum of 2 years' experience in insurance verification, prior authorization processes, diagnostic imaging eligibility requirements and familiarity with durable medical equipment processing.
• Experience in care coordination, specialty referrals, diagnostic imaging, and DME processes.
• Proficiency in electronic health record (EHR) systems and Microsoft Office Suite.
• Excellent computer skills and the ability to evaluate and implement new technologies to enhance efficiency.
• Strong leadership, communication, and organizational skills.
• Excellent communication, interpersonal, and customer service skills.
• Ability to multitask and prioritize tasks effectively.
• Strong attention to detail and accuracy.
• Ability to maintain patient confidentiality.
• Personal and professional passion to help improve healthcare delivery.

 

Working conditions

 

This job operates remotely with occasional on-site meetings or training sessions as required.  Intermittent travel to local centers will also be required for workflow evaluation, process improvement, and collaboration.

 

Physical requirements

 

• Ability to communicate clearly and exchange accurate information constantly.
• Ability to remain stationary for long periods of time.
• Computers, keyboards, phones, and other general office equipment are constantly operated.

 

 

Why Work at AbsoluteCare?

At AbsoluteCare, we serve the most vulnerable individuals in America. These are our neighbors, people who are at higher risk for disease or who have multiple, complex, chronic illnesses. Often, they deal with an unequal healthcare system and wind up seeking basic care from emergency rooms. We take these patients out of those spaces and turn them into members: people who are entitled to some of the best, most focused care this country has to offer. 

We call this “care beyond medicine.” We have turned the doctor’s office into a comprehensive care center. Here, we surround our members with a core care team of doctors, nurses, social workers, and medical assistants who have the time and skills to get to know our members’ needs. We make the most important services available to our members under one roof. This includes a pharmacy, X-rays, a blood lab, nutrition services, urgent care, and much more.

We don’t stop at our four walls. We engage members in the communities where we all live to find the people who need us most. Through these community care teams, we remove the barriers to healthcare that so many people face daily. And it works. 

Our unique care is guided by our core values of accountability, caring, trust, and teamwork. We call it ACT².

AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.

EEO Employer Verbiage: AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.