Care Management Clinician Team Lead
About The Position
The Care Management Clinician Team Lead is accountable for effectively managing Clinical Care Managers for all or assigned lines of business. The role oversees hiring, training, coaching, counseling, and performance evaluation, and may also perform routine day-to-day program functions. The Team Lead participates in program development and implementation, guides team members on company policies and procedures, manages quality and productivity, and works to resolve issues and improve processes and outcomes. The role leads the development, implementation, operation, and maintenance of assigned programs and functions. It monitors team workflow and caseloads, supports staff development and performance, contributes to process improvement using lean methodologies and visual performance boards, and coordinates with other departments and community partners. The position maintains a modified caseload and helps ensure exceptional service to members, providers, employers, agents, and other customers. Travel is required approximately 5% of the time. The work is performed inside in a general office setting with ergonomically configured equipment.
Requirements
- A minimum of five years of clinical experience, including case management experience.
- 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 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 experiencing various health issues and concerns.
- Strong analytical and organizational skills, with 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 and 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 motions such as 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/condition management.
- Prior supervisory experience.
Responsibilities
- Lead development, implementation, ongoing operation, and maintenance of assigned programs, services, or functions.
- Oversee and coach team members to improve departmental performance, processes, and outcomes.
- Monitor daily workflow, caseloads, and work processes to ensure appropriate distribution and processing of tasks.
- Orient and train new hires.
- Provide ongoing supervision, training, evaluation, and leadership to assigned team members, including annual reviews and involvement in promotions or terminations.
- Participate in hiring decisions with the Director and/or Health Services Manager and Human Resources.
- Monitor and take action on team assignments relating to volume, timelines, accuracy, customer service, quality, and performance measures.
- Assist with process improvement and collaborate with other departments to improve interdepartmental processes; use lean methodologies and visual boards to monitor performance indicators and identify improvement opportunities.
- Serve as a liaison with PacificSource departments and community partners to coordinate services and information; serve on committees and document and report relevant communications.
- Use and promote evidence-based tools.
- Maintain a modified caseload consistent with assigned responsibilities.
- Facilitate investigation and resolution of process-related issues and facilitate conflict resolution as needed.
- 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.
- 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, identification of teamwork issues, problem-solving recommendations, and recommendations to standardize Health Services operations.
- Represent the Health Services Department internally and externally as requested by the Health Services Manager and/or Director.
- Perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
