Care Management Clinician Team Lead

PacificSource•Springfield, OR

12h

About The Position

The Care Management Clinician Team Lead is accountable for effective management of Clinical Care Managers for all or assigned lines of business. The role hires, trains, coaches, counsels, and evaluates team members; may perform routine program functions; and participates in program development and implementation. The Team Lead supervises and guides direct reports and other department staff on company policies, procedures, and operations, while managing team quality, productivity, workflow, and the overall effectiveness of the Health Services team. The role works to resolve issues and improve processes and outcomes. The position provides leadership in developing, implementing, operating, and maintaining assigned programs, services, or functions. It monitors workflow, caseloads, assignments, timelines, accuracy, customer service, and performance measures; trains and supervises team members; and collaborates with other departments and community partners to coordinate services. The Team Lead maintains a modified caseload, uses evidence-based tools and lean methodologies, and supports continuous improvement through performance monitoring and visual boards. The role also participates in committees, helps resolve process issues and conflicts, communicates updates to the team, and provides backup to other departmental teams or management staff as needed. The work is performed in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. The listed base salary range is $83,212.29–$137,300.29; actual compensation depends on qualifications, experience, education, and internal equity.

Requirements

At least five years of clinical experience, including case management experience.
An active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), or Licensed Clinical Social Worker (LCSW) credential.
Certified Case Manager (CCM) certification accredited by CCMC, required at hire or within two years of the hire date.
Knowledge of health insurance and state-mandated benefits.
Thorough knowledge and expertise 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 work effectively with people who have varying health issues and concerns.
Strong analytical and organizational skills, including experience using information systems and computer applications.
Flexibility and ability to develop, review, and evaluate utilization and case management reports.
Strong computer skills, including experience with Word, Excel, and PowerPoint.
Ability to use audio-visual equipment.
Ability to work independently with minimal supervision.
Skills in accountable leadership, collaboration, written and verbal communication, critical thinking, decision-making, influencing, active listening, and organization and planning.
Ability to stoop and bend; sit and/or stand for extended periods; perform repetitive motions such as typing, sorting, and filing; and lift and carry files and business materials weighing within light-lifting requirements.
Ability to read and comprehend written and spoken English and communicate clearly and effectively.

Nice To Haves

At least three years of direct health plan experience in case management, utilization management, behavioral health, and/or disease or condition management.
Prior supervisory experience.

Responsibilities

Lead the development, implementation, ongoing operation, and maintenance of assigned programs, services, or functions.
Oversee and coach team members to improve department performance, processes, and outcomes.
Monitor daily workflow, caseloads, and work processes to ensure appropriate task distribution and processing.
Orient and train new hires and provide 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; participate in annual reviews and, as applicable, promotions or terminations.
Monitor and act on team assignments and performance measures related to volume, timelines, accuracy, customer service, and quality.
Assist with process improvement and collaborate with other departments to improve interdepartmental processes.
Use lean methodologies and visual boards to monitor key performance indicators and identify improvement opportunities.
Serve as a liaison with other PacificSource departments and community partners to coordinate service and information.
Serve on internal and external committees as required or designated and report pertinent communications to the team or department.
Use and promote evidence-based tools.
Maintain a modified caseload consistent with assigned responsibilities.
Facilitate investigation and resolution of process-related issues and conflicts.
Oversee and assist in providing exceptional service and information to members, providers, employers, agents, and other customers.
Model effective written and verbal communication.
Provide backup to other departmental teams or management staff as needed.
Meet department and company performance and attendance expectations.
Communicate new or revised policies, procedures, and processes to team members.
Facilitate team operations through information sharing, identifying teamwork issues, developing problem-solving recommendations, and recommending standardization of Health Services operations.
Represent the Health Services Department internally and externally as requested.
Perform other duties as assigned.