Supervisor Case Manager Long-term Care - Delaware (Kent, Sussex, New Castle)

Highmark Health

About The Position

This job manages a team of Case Managers charged with promoting quality member outcomes to optimize member benefits and to promote effective use of resources for members enrolled in DSHP Plus LTSS. Provides direct oversight to Case Managers, meets all of the requirements of a Case Manager and be able to assist in the day to day responsibilities of a Case Manager as needed. This is a full time community based position requiring frequent travel within the assigned territory in Delaware.

Requirements

Bachelor's degree in Social Work or in health, human, or education services and 3 years of experience in long-term care, home health, hospice, public health, or assisted living
Master’s degree in Social Work or in health, human, or education services and 1 year of experience in long-term care, home health, hospice, public health, or assisted living
Registered Nurse or Licensed Practical Nurse and 2 years of experience in long-term care, home health, hospice, public health, or assisted living
Registered Nurse or Licensed Practical Nurse and 2 years of experience in long-term care, home health, hospice, public health, or assisted living in lieu of Bachelor's degree
Leadership skills and be able to relate to all levels of management and staff as well as individuals external to the corporation
Leadership, collaboration, and motivational skills
Ability to multi task and perform in a fast paced, and often intense environment
Excellent written and verbal communication skills
Ability to analyze data, measure outcomes and develop action plans
Team player that possesses strong analytical and organizational skill
The ability to prioritize work demands and meet deadlines
Proficiency in PC-based word processing and database documentation (Word, Excel, Internet, Outlook)
Reliable transportation daily to be able to travel within assigned territory
Ability to meet regulatory deadlines.
Has a dedicated home work space used only for business purposes and is able to comply with all telecommuter policies
Experience in geriatric special needs, behavioral health, home health
Understanding of the importance of cultural competency in addressing targeted populations.
Experience with electronic documentation system(s)
Experience with cost neutrality and budgeting

Nice To Haves

Two years of supervisory or managerial experience.
Certified Case Manager (CCM)
Licensed Bachelors Social Worker (LBSW)
Licensed Masters Social Worker (LMSW)
Licensed Clinical Social Worker (LCSW)
Experience working with HIV/AIDS population
Experience working with behavioral health population
Experience working with developmental disabilities population
Two years in home clinical or case management experience
Medicare and Medicaid experience
Managed care experience

Responsibilities

Manage a team of community based Case Managers.
Promote quality member outcomes to optimize member benefits and to promote effective use of resources.
Act as a role model to staff and assisting in the day to day activities as needed.
Ensure care is medically appropriate, high quality, and cost effective.
Conduct frequent ride-alongs and shadowing of Case Managers for hands on support, quality assurance, and to identify training opportunities.
Apply clinical knowledge to work with facilities and providers for care-coordination.
Participate in rounds with the Medical Director.
Review documentation and processes for consistent practice, and to identify opportunities for growth.
Initiate and implement process improvements.
Assist Case Managers in finding solutions to challenging situations and overcoming obstacles to meeting member’s needs.
Identify and escalate issues appropriately.
Suggest new approaches to complex problems.
Ensure all staff achieve the minimal qualification of their position through ongoing staff development, counsel, individual and group education.
Ensure direct reports meet process and documentation in order to be compliant with regulatory agencies, including but not limited to: NCQA, URAC, CMS, DOH, and DOL.
Develop and implement modifications to ensure appropriate distribution of workload in compliance with Delaware Case Manager caseload requirements.
Recruit, select, orient, evaluate, counsel, and develop performance improvement plans; promote and terminate per corporate policy; and encourage career development and support of staff.
Adhere to all company, State and Federal requirements related to privacy practices, HIPAA, and quality performance standards.
Perform other duties as assigned/requested.