Care Management Clinician – Team Lead
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Job Description
Care Management Clinician Team Lead supervising PacificSource health plan clinical care managers in North Carolina. Improving workflows, service quality, and member care outcomes.
Responsibilities:
- Manage Clinical Care Managers for assigned lines of business
- Hire, train, coach, counsel, and evaluate team member performance
- Lead development, implementation, operation, and maintenance of assigned programs, services, or functions
- Monitor daily workflow, caseloads, task distribution, volume, timelines, accuracy, customer service, and performance measures
- Provide orientation, ongoing supervision, training, evaluation, and leadership to assigned team members
- Participate in hiring decisions with the Director and/or Health Services Manager and Human Resources
- Assist with process improvement and interdepartmental processes using lean methodologies and visual boards
- Serve as liaison with PacificSource departments and community partners
- Serve on internal and external committees as required
- Utilize and promote evidence-based tools
- Maintain a modified caseload
- Facilitate investigation and resolution of process-related issues and conflicts
- 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 policies, procedures, and processes to team members
- Facilitate team operations through information sharing, problem-solving recommendations, and standardization of Health Services operations
- Represent the Health Services Department internally and externally
- Meet department and company performance and attendance expectations
- 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
- Ability to deal effectively with people who have various health issues and concerns
- Strong analytical and organizational skills with 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
- Ability to read and comprehend written and spoken English
- Ability to communicate clearly and effectively
- Ability to stoop and bend, sit and/or stand for extended periods, perform repetitive motions, and lift/carry files and business materials
Benefits:
- Equal opportunity employment
- Ergonomically configured equipment
- Professional development through orientation, training, coaching, and ongoing leadership
- Work-from-home arrangement
- Paid travel for approximately 5% of work time
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