Supervisor, Care Coordination

Medica•Minnetonka, MN

2d•Hybrid

About The Position

Medica is a nonprofit health plan serving over a million members across multiple states, focusing on personalized healthcare experiences and provider partnerships. We are a collaborative team that values accountability, data-driven decisions, and continuous learning. Our mission is to support our members and employees during significant life moments. This role involves managing a team of care coordinators who provide services for State Public Programs and other Medica members, with a primary focus on Care Coordination Products within State Public Programs. The position offers direct supervision to Care Coordinators and has oversight of an assigned panel of members, ensuring the daily operations and clinical care for these members are managed effectively. This includes mentoring, training, and fostering team cohesion, educating the team on utilizing membership information for member care, coordinating care for vulnerable populations, managing clinical care coordination according to guidelines, and monitoring team performance through audits to ensure member satisfaction and regulatory compliance. The role also supports the Manager, Care Coordination in implementing and evaluating services, and developing improvement plans as needed.

Requirements

RN Diploma or Degree in Nursing (Associates or Bachelors) + a minimum of 2 years’ experience in community based services, OR Bachelor's degree in Social Work + a minimum of 1-2+ years of community based services
5+ years clinical experience
1-2+ years supervisory experience of professional staff, including employees who are home office or located remotely; informal leadership that has included coaching and mentorship will also be considered
Active, unrestricted RN OR SW License in the state of MN
Public Health Certification preferred, however not required
Excellent customer service skills and proven team building skills
Excellent computer skills and ability to leverage technology to lead remote teams
High degree of initiative and ability to work independently, and within a group
Ability to plan, organize and prioritize work effectively, including the flexibility to accommodate frequent changes
Strong problem solving skills
Consultant skills to articulate business needs and translate to quality programs that result in targeted staff competencies
Strong leadership skills
Must be legally authorized to work in the United States at the time of application.
Employment is contingent on verification of identity and eligibility to work in the United States.

Nice To Haves

MnCHOICES Certified Assessor Training (MNCAT) preferred or ability to obtain within 21 days of employment

Responsibilities

Provide direct supervision to the team assigned to the panel of members.
Communicate accurately and timely information to team members to enhance their effectiveness and the efficiency.
Foster positive team dynamics and encourages team members to support one another.
Conduct routine team meetings.
Monitor the care coordinators performance throughout the year including the progress towards goals, clinical performance and clinical documentation.
Recognize and reward good work.
Conduct joint member visits with care coordinators, chart reviews and completion of audit tools.
Review charts in preparation for external and internal audits.
Adjust the Care Coordinator workload, caseload totals and monthly visits/contacts on a routine bases, following consultation with Clinical Care Manager.
Provide thoughtful, fair and accurate evaluation of each team member.
Deliver feedback throughout the year and annually in accordance with human resources policies, procedures and tools.
Implement training and development opportunities for the Care Coordinators.
Monitor care coordinators training, licenses and certifications including MnCHOICES.
Be willing to manage a caseload of member base on caseload size and member needs of the panel of members.
Educate team and acts as a resource for issues that arise.
Share community knowledge of health and supportive services with clinical team.
Research and respond to question posed by team.
Train, mentor and develop Care Coordinators.
Mentor newly hired Care Coordinators and supervise all aspects of their training.
Establish orientation and training process and update process and tools based on feedback, experience and/or recommendations.
Instruct care coordinators on how to keep themselves safe when in the community and provide guidelines.
Assign members to the most appropriate care coordinator to meet member’s needs and administrative budget.
Improve the effectives and efficiency of the team’s performance.
Instruct team on prescribed policies and procedures as well as best practices to ensure compliance with regulatory and contractual requirements.
Instruct team on the model of care for the vulnerable populations and how to coordinate the medical, social service, mental health and chemical health of the members.
Offer suggestions for improvement and participation in revision/modification to current processes and/or creation of new.
Instruct care coordinators on how to leverage interdisciplinary team for member consultation to meet member’s medical and social needs.
Ensure care coordinators develops appropriate care plan for members and communicates progress with physicians, members, family and providers.
Conduct interdisciplinary care team reviews and care coordinator home office audits.
Work with Medica Care System sales, operations and regulatory teams to share information, identify needs and promote continuity of care for members.
Work to foster relationships within team and within Medica, willing represent Medica for outreach to member or potential member groups and participates in SPP and organization-wide projects as requested.
Display exemplary care coordination skills, when needed, as it relates to clinical knowledge, working with members, completing all required documentation and timeliness of all member related work.
Participate in on-call program as needed.
Monitor team metrics to ensure timely completion of member assessment (Initial, annual and others) and data entry into state’s MMIS tracking system.
Track and evaluate timeliness of members’ assessments by care coordinators.
Identify any assessments at risk for timely completion and take action with care coordinators as needed.
Follow through on instructions from Clinical Care Manager to increase care coordinators contact with member based on membership stratification into care levels, the MCS Enhanced Care Coordination (ECC) Model.
Complete the care coordination assignment process, upon receipt of the routine enrollment lists, to ensure operational and administrative efficiencies.
Conduct audits as instructed to demonstrate compliance with regulatory and contractual requirements.
Implement corrective action plans as needed.
Monitor the members’ Elderly Waiver (EW) budget against guidelines and instructs care coordinators about each member’s utilization of services.
Monitor the members’ Medicaid Eligibility and instructs care coordinator about each member’s renewal.
Utilize additional data collection tools, systems and reports to support operational performance and improvement.
Create and implement corrective action plans as needed.