Complex Care - Team Lead

Marin Community Clinics•Novato, CA

1d•$30 - $35•Hybrid

About The Position

Marin Community Clinics, founded in 1972, is today, a multi-clinic network with a wide array of integrated primary care, dental, behavioral, specialty and referral services. As a Federally Qualified Health Center (FQHC), we provide vital health services to almost 40,000 individuals annually in Marin County. The Clinics regularly receive national awards from the Health Resources and Administrations (HRSA). Our Mission is to promote health and wellness through excellent, compassionate care for all. The Complex Care Team Lead works to advance our goal of improving health outcomes for individuals experiencing complex medical, behavioral health and psychosocial needs. The Complex Care Team Lead works collaboratively with primary care, behavioral health, and other members of the clinical care team. This position provides leadership and support to a team of Associate Case Managers to ensure the highest level of patient care and staff satisfaction. The Team Lead is a patient-facing role that supports engagement and builds trust with patients with complex medical and psychosocial needs. The Team will report to the Complex Care Clinical Supervisor.

Requirements

1 year experience in case management healthcare setting.
1 year experience in a healthcare setting.
Completion of Lay Counselor Academy or equivalent certification/training.
Must be fluent in English with the ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
Ability to write reports and business correspondence in English.
Must be able to communicate with patients and partners in Spanish: effectively present information and respond to questions from clients, customers, and the public in Spanish.
To perform this job successfully, an individual must be computer literate and knowledgeable in Microsoft Office software programs, and how to conduct searches on the Internet.
Current BLS Certificate
Valid Driver's License.
Fullfill immunization and fit for duty regulatory requirements.
Prolonged periods of sitting at a desk and working on a computer.
Must be able to lift to 15 pounds at times.
Ability to drive to clinics and other locations in the community.

Nice To Haves

Experience and expertise serving complex care patients; particularly patients experiencing homelessness, adverse experiences, and complex medical conditions.
Demonstrates experience/initiative in program development and improvement.
Demonstrates leadership in the field of Complex Care.
Can effectively give and receive feedback.
Has demonstrated excellent coalition building skills and is comfortable working with community partners including community-based organizations (CBOs), Marin County, medical/BH specialists, and insurance providers.
Has excellent organizational skills.
Is comfortable working with individuals with complex behavioral health presentations and/or substance use disorders.
Has passion for helping individuals navigate a complex system of care.
Is a team player and welcomes guidance from multidisciplinary team members.
Demonstrates initiative, creativity, and enjoys problem solving.
Ascribes to the tenets of person-centered, adverse experiences-informed, housing-first care.
Demonstrates compassion and respect for individuals served in all interactions.
Demonstrates a willingness to be flexible and adaptable in all aspects of this work.
1-2 years’ experience (and passion for) providing support to individuals with chronic and complex BH needs, complex medical conditions and/or substance-using individuals highly preferable.
Strong preference for knowledge/experience with CalAIM ECM initiatives.
Knowledge of state regulations and legal/ethical standards related to patient rights, and client/patient confidentiality required.
Training in motivational interviewing highly desired/or willingness to learn.
Strong preference for a candidate than can conduct clinical assessment interviews and case management interventions with patients in Spanish.

Responsibilities

Works closely with a team of Associate Case Managers to ensure the delivery of high-quality, equitable, person-centered case management to MCC patients.
Will complete new -patient assessments with Associate Case Mangers to ensure quality.
Ensures robust onboarding and ongoing training/education for Associate Case Managers.
Works closely with the Complex Care Clinical Supervisor for ongoing program development.
Maintains expertise in Complex Care initiatives like CalAIM/ECM.
May participate in interviewing/hiring staff.
Facilitate internal and external case conferencing.
Attend meetings with critical external partners.
Provide program development support (creating workflows, grant participation, program evaluation, etc.).
Ensure program reporting requirements and quality measures are met.
Maintains a caseload of up to 15 patients.
Conduct home/community visits as needed.
Document all Patient interactions and services using MCC’s electronic health record AND secondary database.
Attend internal and external meetings (i.e., case conferencing, administrative).
Attend relevant trainings such as health coaching, engagement techniques, etc.
Timely and accurate reporting of data as requested to MCC CM programs.
May travel between clinics or meet patients in the community as needed.
Provide frank and considered opinions regarding case management services and quality improvement measures.
Other duties may be assigned (including maintaining small caseload).