Full employer posting
The Chronic Care Nurse Supervisor serves as the clinical lead and administrative supervisor for chronic care management (CCM), Principal Care Management (PCM), Transitional Care Management (TCM), Emergency Department (ED) transitional care, and transfer transitional care programs at North Texas Medical Center (NTMC). This position provides clinical leadership, operational oversight, and direct supervisory management across clinic care coordination teams, chronic disease navigation programs, and population health initiatives.
Oversees daily operations, manages clinical staff performance (including staff RNs, chronic care navigators, and clinic patient navigators), leads quality improvement initiatives, and ensures the delivery of high-quality, evidence-based chronic care services. Combining clinical expertise with supervisory responsibilities, the Chronic Care Nurse Supervisor coordinates comprehensive care plans with primary care providers, specialists, case managers, and allied health professionals while ensuring compliance, billing accuracy, and adherence to hospital policies.
SUMMARY OF ESSENTIAL JOB FUNCTIONS Clinical Leadership & Team Supervision Supervises clinical personnel within the chronic care management department, including staff RNs, Chronic Care Nurse Navigators, and Clinic Patient Navigators, providing workflow coordination, scheduling, and performance evaluations. Serves as a clinical resource person and subject matter expert in chronic disease management, care coordination, and complex patient navigation.
Manages recruitment, orientation, competency evaluations, and professional development of care management staff in collaboration with nursing leadership. Holds staff accountable for clinical judgment, critical thinking, customer service, and compassionate patient care. Leads daily departmental huddles, coordinates clinic workflow, and resolves operational bottlenecks or clinical escalations promptly.
Chronic Care Management & Patient Navigation Oversees the development, implementation, and continuous evaluation of individualized chronic care plans tailored to patients with multi-morbid conditions, diabetes, cardiovascular disease, respiratory illness, and other chronic conditions. Ensures effective patient advocacy, self-management education, medication reconciliation, and barrier identification (e.g., transportation, financial constraints, social determinants of health).
Manages referrals, diagnostic test coordination, and specialist appointments to ensure seamless care transitions across inpatient, outpatient, and community settings. Maintains active engagement with primary care providers, clinic patient navigators, and external support agencies to optimize patient outcomes and prevent avoidable hospital readmissions. Directs specialized care management programs including Principal Care Management (PCM) for high-risk patients with single complex chronic conditions, and oversees structured Transitional Care Management (TCM) services to support patients transitioning from inpatient acute settings to post-discharge care.
Manages Emergency Department (ED) transitional care processes to ensure timely follow-up, post-ED discharge tracking, and diversion strategies, as well as transfer transitional care programs to facilitate smooth patient handoffs during inter-facility or regional transfers. Quality Improvement, Compliance & Billing Management Participates in quality assessment and improvement programs, tracking quality metrics, patient satisfaction scores, and clinical outcomes for chronic disease populations.
Monitors documentation compliance within the Electronic Health Record (EHR) system for accuracy, timeliness, and alignment with nursing protocols and regulatory standards. Oversees reimbursement, compliance, and billing management for Chronic Care Management (CCM), Principal Care Management (PCM), Transitional Care Management (TCM), and related quality programs, identifying areas for process enhancement. Program Coordination & Interdisciplinary Collaboration Conducts interdisciplinary team meetings and clinical case reviews with physicians, nurse practitioners, case managers, social workers, and dietitians as needed.
Functions as a liaison between clinic administration, medical staff, patients, families, and community healthcare partners. BASIC SKILLS Clinical Expertise: Deep knowledge of chronic disease processes, care management protocols, pharmacological management, and patient education principles. Leadership & Supervision: Proven capability to direct workflows, evaluate staff performance, resolve interdisciplinary conflicts, delegate tasks, and foster team cohesion.
Strong critical thinking and problem-solving abilities. EHR & Technical Competence: Advanced proficiency in electronic health record (EHR) systems, medical billing compliance, and reporting tools. Communication: Exceptional oral and written communication skills suitable for interdisciplinary collaboration, executive reporting, patient advocacy, and community outreach.
Work Style: Ability to work independently and as part of a multidisciplinary team; and compassionate and empathetic approach to patient care. EDUCATION, LICENSURE AND EXPERIENCE
Associate's Degree in Nursing (ADN) required. Bachelor of Science in Nursing (BSN) preferred. Master of Science in Nursing (MSN) preferred.
Licensure/Certification: Current, unencumbered Registered Nurse (RN) license in Texas, OR Current, unencumbered Registered Nurse (RN) license in a recognized Compact State Current American Heart Association Basic Life Support (BLS) certification required upon hire. Certification in Chronic Care Management (CCM), Certified Case Manager (CCM), or Certified Diabetes Care and Education Specialist (CDCES) preferred.
Minimum of 2-5 years of direct clinical nursing experience in chronic care management, ambulatory care, case management or acute care nursing. One to two (1–2) years of demonstrated clinical supervisory, charge nurse, or care coordinator leadership experience preferred. LANGUAGE SKILLS Ability to communicate effectively both verbally and written.
Additional language is a plus PHYSICAL REQUIREMENTS Prolonged periods of standing, walking, sitting, bending, and reaching in clinical and office settings. Primary operation in outpatient clinic and medical office environments, with occasional local travel for community health initiatives. Must be able to sit for extended periods of time.
Must be able to lift 25 pounds Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care.
About the role
This position provides clinical leadership, operational oversight, and direct supervisory management across clinic care coordination teams, chronic disease navigation programs, and population health initiatives.