Team Lead, Care Management

ArchWell Health•Phoenix, AZ

14d

About The Position

ArchWell Health is re-imagining the practice of primary care. We are putting the relationship between patient and physician at the center of a value-based model focused on outstanding patient experience, improved access, and better outcomes. In our medical clinics, we provide comprehensive primary care for senior adults with traditional Medicare and Medicare Advantage plans, focused on delivering improved quality, better patient experience and lower total cost of care. Job Summary The Care Management Team Lead will be an integral part of the clinical leadership team. The Care Management Team Lead is primarily responsible for recruiting, onboarding, leading, and performance managing the Care Managers that support transitions of care and management of high-risk individuals in multiple markets and states, in an outpatient geriatric primary care setting. The Care Management Team Leader will provide leadership oversight and support for principal functions of clinical utilization to drive improvement of value-based care.

Requirements

Ability to travel to visit centers within assigned markets to provide audits, clinical education, and training for members of the clinical team (<20% travel)
Excellent presentation, verbal, and written communication skills
Strong interpersonal communication skills with exceptional active listening abilities
Mission driven and motivated to join an organization that will transform the way we deliver accessible, clinically excellent care to seniors
Passion for providing care to culturally diverse and medically complex populations and underserved communities
Registered Nurse from an accredited college; BSN preferred, with an active Registered Nurse license
A minimum of 3 years clinical work experience, required required
A minimum of 2 years as a care manager, required
Previous management experience in a health system, health plan, or other care delivery organization required
Willingness and ability to maintain current and new licensure or certification requirements as mandated by state regulations

Nice To Haves

Experience managing a remote team highly preferred
Certified Case Manager certification through the Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) highly desired
Managed care experience including knowledge of HEDIS and CMS guidelines

Responsibilities

Lead a team of remote and/or market-based RN Care Managers and support staff, including interviewing, hiring, training, market support, and colleague coaching and development
Analyze quality performance at the center and market level, and collaborate closely with clinical leadership and operations when there are opportunities for improvement
Develop and manage team to meet or exceed established goals
Serve as a role model and function as a clinical resource for the Care Management team
Supervise and facilitate team development, and oversee the day-to-day tasks/activities in the department
Ensure team members are competent in the use of EMR (eCW), care management platform, and other online tools
Work collaboratively and maintain active communication with providers, nurses, and other members of the multidisciplinary care team to effect timely, appropriate member management
Monitor the quality of RN Care Manager interactions with members, families, physicians, and the multidisciplinary team by regularly shadowing team to ensure clear understanding and adherence to department processes
Monitor quality of documentation and assessments by regularly auditing the RN Care Managers’ documentation
Participate in clinical performance improvement activities
Complete daily, weekly, and monthly reports as assigned by leadership
Seek ways to control costs without compromising member safety, quality of care, or the services delivered
Adhere to established policy and procedure and standards of care; escalate issues promptly through the established chain of command
Demonstrate knowledge of regulatory requirements, ArchWell Health compliance policies, and quality initiatives
Serve as an advocate for members’ rights, needs, and values; ensure that members’ ethnic, cultural, or religious values, beliefs, preferences, and needs are considered and aligned
Perform other duties as assigned