Job SummaryThe 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.
Duties/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
Required Skills/Abilities:- Ability to travel to visit centers within assigned markets to provide audits, clinical education, and training for members of the clinical team (
- 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
Education and Experience:- 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
- 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
- Willingness and ability to maintain current and new licensure or certification requirements as mandated by state regulations
