Team Lead, Community Based Care Management - RN

Job Summary

The Team Lead, Community Based Care Management provides front line management and support to departmental leadership in the development and execution of the Care Model in alignment with corporate goals

Essential Functions

• Functions as a “hands-on” supervisor, assisting in day-to-day operations and supervision of staff with adherence to departmental expectations
• Responsible for recruiting, hiring, onboarding, training and ongoing support of the departmental team
• Conducts meetings as needed (face to face or virtually) to train, lead, and support staff towards the effective administration of CM program
• Prepares and utilizes reports to monitor and audit all systems, procedures and the quality of customer services provided. Assist with representing the unit at Departmental and Planning meetings as requested
• Ensures staffing policies, procedures and SOPs are standardized and are current to meet business needs
• Assists the Managers as needed in the review and development of new projects/processes as requested by the health plans
• Oversee appropriate system documentation within defined protocols and guidelines
• In support of the Strategic Plan, serve as the technical and content support to align programs/processes
• Serve as interdepartmental liaison, collaborating with internal resources in monitoring service levels to meet requirements and analyze for trends
• Participate in meetings with internal/external resources to provide information about services and benefits available to members and referral mechanisms
• Assist in arranging and coordinating services with community partners to maximize utilization of appropriate community resources and support groups
• Participant in development of budget and perform ongoing monitoring of status
• Assist with implementation of interventions to maintain and/or improve the quality and efficiency of the operations/services provided
• Perform any other job duties as requested

Education and Experience

• Completion of an accredited registered nursing (RN) degree program, Bachelor’s Degree in Social Work, or Master's degree as relevant to licensure eligibility is required
• A minimum of three (3) years of healthcare experience is required
• A minimum of two (2) years of managed care and/or case management experience is preferred
• Previous supervisory experience is preferred

Competencies, Knowledge and Skills

• Ability to display a customer service, member-focused orientation
• Ability to travel as required by the needs of the business
• Strong data analysis and trending skills
• Strong team and staff development skills
• Strong collaboration and conflict resolution skill sets
• Ability to develop, prioritize and accomplish goals/time management
• Strong decision making and problem solving skills
• Exceptional communication skills (both written and verbal) with the ability to present information in a variety of different formats
• Effective listening and critical thinking skills
• Strong ability to teach best practice, engagement strategies for successful member participation (including motivational interviewing, best practice engagement techniques)
• Knowledge of state and federal healthcare regulations and environment
• Ability to work in a fast-past environment
• Ability to work independently and within a team environment
• Advanced knowledge of Microsoft Word, Excel, PowerPoint and Visio
• Ability to operate smart phone, iPad or other mobile communication devices

Licensure and Certification

• Active, unrestricted Registered Nurse (RN) license, Social Work license, or Counselor license is required
• Case Management certification is preferred
• Must have valid driver’s license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver’s license record check and verified insurance. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in the position will be terminated.
• To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
• CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.

Working Conditions

• This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. May be exposed to weather conditions typical of the location.
• Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need
• May be required to travel greater than 50% of time to perform work duties.
• Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer