Care Management Clinician Team Lead
Company: PacificSource Health Plans
Posted on: August 18, 2019
Position Overview: Accountable for the effective management of the
Clinical Care Managers for all lines or assigned lines of business
Responsible for hiring, training, coaching, counseling, and
evaluating team member performance. May be called upon to perform
routine day-to-day program functions. Actively participate in
program development and implementation. Supervise and provide
guidance to direct reports and other department staff regarding
company policies, procedures, and operations. Manage the quality
and productivity of team tasks and workflow as they relate to both
assigned functions and the overall effectiveness of the Health
Services team. Work to resolve issues and improve processes and
- Take a leadership role in the development, implementation, and
ongoing operation and maintenance of assigned programs, services,
- Improve the performance of the department through effective
oversight and coaching of team members, managing team performance
and improving processes and outcomes. Monitor daily workflow and
caseloads and other work processes of team to assure appropriate
distribution and processing of tasks.
- Responsible for the orientation and training of new hires.
- Provide ongoing supervision, training, evaluation, and
leadership to assigned team members. This may include annual
reviews, involvement in promotions and/or terminations of
- Participate in hiring decisions in concert with Director and/or
Health Services Manager and Human Resources.
- Monitor, evaluate and take action on team assignments relating
to volume, timelines, accuracy, customer service, and other quality
and performance measures as appropriate.
- Assist with process improvement and work with other departments
to improve interdepartmental processes. Utilize lean methodologies
for continuous improvement. Utilize visual boards to monitor key
performance indicators and identify improvement opportunities.
- Serve as liaison with other PacificSource departments or
community partners to coordinate optimal provision of service and
information. Serve on various internal and external committees as
required or designated. Document and report any pertinent
communications back to the team or department.
- Utilize and promote use of evidence-based tools.
- Maintain modified caseload consistent with assigned
- Facilitate investigation and resolution of process-related
issues as needed. Facilitate conflict resolution, including
interfacing with affected departments and individuals, as
- Oversee and assist in providing exceptional service and
information to members, providers, employers, agents, and other
external and internal customers.
- Practices and models effective communication skills; both
written and verbal.
- Provide backup to other departmental teams or management staff,
as needed. Supporting Responsibilities:
- Meet department and company performance and attendance
- Relate new or revised policies, procedures and/or processes to
team members to ensure they have the most up-to-date and current
- Facilitate team operations by discussions through the sharing
of information and knowledge, identification of teamwork issues,
development of problem-solving recommendations, and recommendations
of standardizing Health Services operations.
- Represent the Heath Services Department, both internally and
externally, as requested by Health Services Manager and/or
- Perform other duties as assigned.Work Experience: A minimum of
five years clinical experience, including case management
experience required. Minimum of three years direct health plan
experience in the following areas: case management, utilization
management, behavioral health, and/or disease/condition management
strongly preferred. Prior supervisory experience preferred.
Education, Certificates, Licenses: Registered Nurse or Licensed
Clinical Social Worker or Licensed Professional Counselor with
current appropriate unrestricted state license. Certified Case
Manager Certification, or equivalent, strongly desired or
willingness to obtain certification within 2 years of hire.
Knowledge: Knowledge of health insurance and state mandated
benefits.Thorough knowledge, experience and expertise in case
management practice including; advocacy, assessment, planning,
communication, education, resource management, and service
facilitation. Effective adult education/teaching and/or group
leadership skills. Ability to deal effectively with people who have
various health issues and concerns. Strong analytical and
organizational skills with experience in using information systems
and computer applications. Demonstrates flexibility. Ability to
develop, review, and evaluate utilization and case management
reports. Strong computer skills including experience with Word,
Excel, and PowerPoint. Ability to use audio-visual equipment.
Ability to work independently with minimal supervision.
Competencies Our Values
- Building Trust
- Building a Successful Team
- Aligning Performance for Success
- Building Customer Loyalty
- Building Strategic Work Relationships
- Continuous Improvement
- Decision Making
- Facilitating Change
- Leveraging Diversity
- Driving for Results
- We are committed to doing the right thing.
- We are one team working toward a common goal.
- We are each responsible for our customers' experience.
- We practice open communication at all levels of the company to
foster individual, team and company growth.
- We actively participate in efforts to improve our many
communities-internal and external.
- We encourage creativity, innovation, continuous improvement,
and the pursuit of excellence. Environment: Work inside in a
general office setting with ergonomically configured equipment.
Travel is required approximately 5% of the time. Physical
Requirements: Stoop and bend. Sit and/or stand for extended periods
of time while performing core job functions. Repetitive motions to
include typing, sorting and filing. Light lifting and carrying of
files and business materials. Ability to read and comprehend both
written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and
level of work performed by employees within this position and is
subject to change. It is not designed to contain or be interpreted
as a comprehensive list of all duties, responsibilities, and
qualifications required of employees assigned to this position.
Employment remains AT-WILL at all times. PacificSource is an equal
opportunity employer. All qualified applicants will receive
consideration for employment without regard to status as a
protected veteran or a qualified individual with a disability, or
other protected status, such as race, religion, color, national
origin, sex, sexual orientation, gender identity or age.
Keywords: PacificSource Health Plans, Bend , Care Management Clinician Team Lead, Executive , Bend, Oregon
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