Care Manager Supervisor

Health Services for Children with Special Needs•Washington, WA

3d•Onsite

About The Position

The Supervisory Care Manager is responsible for the mentoring, training and clinical supervision of care management staff and oversight of staff caseloads of enrollees who have mild to complex medical and mental/behavioral health needs. This position has a broad knowledge base related to the needs of the Medicaid population and is an integral member of the Care Management Leadership team. The Supervisory Care Manager supports the operations of the Care Management Department through monitoring of staff's adherence to quality and productivity standards; assisting with responding to enrollee's needs; and providing clinical supervision and leadership for compliance and performance improvement.

Requirements

Bachelor's Degree Nursing, Social Work, Health Services (Required)
Understanding of Medicaid benefits
Excellent verbal and written communication skills
Familiarity with computer systems and applications.
Computer literate in Microsoft suite
Strong organizational skills
Ability to interpret and apply departmental requirements
Ability to make sound decisions and use good judgment
Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service
Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practice
Ind. Clinical Social Worker Licensed in District of Columbia Upon Hire (Required) Or Registered Nurse Licensed in District of Columbia Upon Hire (Required)

Nice To Haves

Master's Degree Nursing, Social Work, Health Services (Preferred)
3 years progressive supervisory experience preferred (Preferred)
3 years of related experience in managed care and /or care management preferred (Preferred)
Certification in Case Management (Preferred)

Responsibilities

Responsible for day to day operations of an assigned team
Responsible for a team of up to 12 licensed and unlicensed care management staff
Reviews cases regularly with staff; acts as a clinical consultant regarding care management issues; guides clinical staff with review of assessments and care plans, evaluates utilization reviews and/or documentation
Assists Associate Directors and Director in establishing, implementing, and ensuring care management policies, practices, and procedures are in place
In conjunction with the Associate Directors and Director, coordinates, develops and implements action plan to respond to areas of need
Leads and offers expert guidance and direct supervision to the team in aspects of care management\: assessment, planning and implementation, coordination
Assist the team with monitoring, and evaluation of options and services to meet the routine and complex health and behavioral health care needs of members
Monitors work performed by team members according to organization, department and community standards
Monitors productivity through the use of various reports to support appropriate outcomes and assign corrective action plans to staff as needed for immediate review and resolution
Conducts regular team meetings in accordance with contractual agreement and as needed
Responsible to complete all annual performance reviews for assigned staff
Applies advanced problem-solving and analytical skills to evaluate and address complex situations involving members, providers, staff and community professionals
Submits routine and special reports as assigned or requested.
Participates in internal and external multidisciplinary team meetings.
Attends/conducts meetings internally or externally with other government agencies or community organizations involved with enrollees in the health plan as needed
Conducts weekly/bi-weekly supervision with assigned staff
Responsible for oversight of assigned staff in maintaining caseload and contractual compliance metrics