Care Management Clinician Team Lead

PacificSource • Portland, OR

1d

About The Position

The Care Management Clinician Team Lead is accountable for effectively managing Clinical Care Managers across assigned lines of business. The role leads program development, implementation, operations, and maintenance; supervises and supports team members; and oversees workflow, quality, productivity, and performance. The lead may also perform routine program functions and maintain a modified caseload consistent with assigned responsibilities.

The position supports process improvement, resolves operational and team issues, coordinates with other departments and community partners, and helps ensure high-quality service to members, providers, employers, agents, and other customers. It also represents Health Services internally and externally as requested. The work is performed in a general office setting with ergonomically configured equipment, and travel is required approximately 5% of the time.

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 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 work effectively with people who have various health issues and concerns.
• Strong analytical and organizational skills, including experience with information systems and computer applications.
• Flexibility and the ability to develop, review, and evaluate utilization and case management reports.
• Strong computer skills, including experience with Word, Excel, and PowerPoint; ability to use audiovisual 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 planning and organization.
• Ability to stoop and bend; sit and/or stand for extended periods; perform repetitive typing, sorting, and filing; and lift and carry files and business materials.
• 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.
• Manage, coach, supervise, train, evaluate, and provide guidance to assigned team members; participate in hiring decisions and may be involved in promotions or terminations.
• Monitor daily workflow, caseloads, assignments, and performance measures to ensure appropriate distribution, timely processing, accuracy, quality, and customer service.
• Orient and train new hires and communicate current policies, procedures, and processes to team members.
• Improve department performance, processes, and outcomes, including using lean methodologies and visual boards to monitor key performance indicators and identify improvement opportunities.
• Coordinate with other departments and community partners to support service delivery and improve interdepartmental processes.
• Serve on internal and external committees as required or designated and report pertinent communications to the team or department.
• Promote and use evidence-based tools, maintain a modified caseload, and facilitate investigation and resolution of process-related issues.
• Facilitate conflict resolution, including coordination with affected departments and individuals.
• Oversee and assist in providing service and information to members, providers, employers, agents, and other internal and external customers.
• Model effective written and verbal communication and provide backup to other departmental teams or management staff as needed.
• Meet department and company performance and attendance expectations; perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed