Care Management Clinician Team Lead
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Job Description
Care Management Clinician Team Lead overseeing clinical care teams and health services operations for PacificSource health insurance members. Coaching staff, improving processes, and coordinating member care.
Responsibilities:
- Manage Clinical Care Managers for assigned lines of business
- Hire, train, coach, counsel, and evaluate team member performance
- Participate in program development, implementation, operation, and maintenance
- Supervise direct reports and provide guidance on company policies, procedures, and operations
- Manage team quality, productivity, workflow, assignments, caseloads, timelines, accuracy, customer service, and performance measures
- Monitor daily workflow and caseloads to ensure appropriate task distribution and processing
- Orient and train new hires
- Provide ongoing supervision, training, evaluation, and leadership, including annual reviews and involvement in promotions or terminations
- Participate in hiring decisions with leadership and Human Resources
- Assist with process improvement using lean methodologies and visual boards
- Serve as liaison with PacificSource departments and community partners
- Serve on internal and external committees as assigned
- Promote and utilize evidence-based tools
- Maintain a modified caseload
- Investigate and resolve process-related issues and facilitate conflict resolution
- Oversee and assist with service and information delivery to members, providers, employers, agents, and other customers
- Provide backup to departmental teams or management staff
- Communicate policy, procedure, and process changes to team members
- Facilitate team operations, information sharing, problem-solving, and standardization of Health Services operations
- Represent the Health Services Department internally and externally
- Perform other duties as assigned
Requirements:
- Minimum of five years clinical experience, including case management experience
- Minimum of three years direct health plan experience in case management, utilization management, behavioral health, and/or disease/condition management strongly preferred
- Prior supervisory experience preferred
- Active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), or Licensed Clinical Social Worker (LCSW) credential required
- Certified Case Manager Certification (CCM) accredited by CCMC required at time of hire or within two years of hire date
- Knowledge of health insurance and state mandated benefits
- Thorough knowledge and experience in case management practice, including advocacy, assessment, planning, communication, education, resource management, and service facilitation
- Effective adult education/teaching and/or group leadership skills
- Strong analytical and organizational skills
- Experience using information systems and computer applications
- Ability to develop, review, and evaluate utilization and case management reports
- Strong computer skills, including Word, Excel, and PowerPoint
- Ability to use audio-visual equipment
- Ability to work independently with minimal supervision
- Skills in accountable leadership, collaboration, written/verbal communication, critical thinking, decision making, influencing, active listening, and organizational planning
- Ability to read and comprehend written and spoken English
- Ability to communicate clearly and effectively
- Ability to stoop, bend, sit and/or stand for extended periods, and perform repetitive typing, sorting, and filing
- Light lifting and carrying of files and business materials
- Travel approximately 5% of the time
Benefits:
- Equal opportunity employment
- Ergonomically configured equipment
- Professional development through orientation, training, coaching, counseling, and ongoing evaluation
- Team member support and leadership development
- Employment remains at-will
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