Care Management Clinician – Team Lead
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Job Description
Clinician Team Lead managing PacificSource health plan case management teams and care programs. Supervising staff, improving workflows, and coordinating member services remotely in North Carolina.
Responsibilities:
- Manage Clinical Care Managers across assigned lines of business
- Hire, train, coach, counsel, supervise, and evaluate team members
- Lead development, implementation, operation, and maintenance of assigned programs, services, and functions
- Monitor team workflow, caseloads, assignments, volume, timelines, accuracy, customer service, and performance measures
- Improve department performance, processes, and outcomes using lean methodologies and visual boards
- Orient and train new hires
- Participate in hiring, promotion, and termination decisions
- Assist with interdepartmental process improvement
- Serve as liaison with PacificSource departments and community partners
- Serve on internal and external committees and communicate pertinent information to the team
- 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 for members, providers, employers, agents, and other customers
- Provide backup to departmental teams or management staff
- Communicate updated policies, procedures, and processes to team members
- Facilitate team operations, knowledge sharing, problem solving, and standardization of Health Services operations
- Represent the Health Services Department internally and externally
- Perform other duties as assigned
Requirements:
- Minimum five years of clinical experience, including case management experience
- Minimum three years of direct health plan experience in case management, utilization management, behavioral health, and/or disease/condition management strongly 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 (CCM) certification accredited by CCMC required at hire or within two years of hire
- 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
- Ability to read and comprehend written and spoken English
- Ability to communicate clearly and effectively
- Approximately 5% travel required
- Ability to stoop, bend, sit and/or stand for extended periods, and perform repetitive typing, sorting, and filing
- Ability to lift and carry files and business materials
Benefits:
- Equal opportunity employment
- Work-from-home arrangement in North Carolina
- Ergonomically configured equipment
- Professional development through orientation, training, coaching, and ongoing education
- Annual reviews and opportunities for promotion
- Travel approximately 5% of the time
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