🔥 13 hours ago
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• Manage Clinical Care Managers for assigned lines of business • Hire, train, coach, counsel, and evaluate team member performance • Participate in program development, implementation, operation, and maintenance • Supervise direct reports and provide guidance on company policies, procedures, and operations • Manage team quality, productivity, workflow, assignments, caseloads, timelines, accuracy, customer service, and performance measures • Monitor daily workflow and caseloads to ensure appropriate task distribution and processing • Orient and train new hires • Provide ongoing supervision, training, evaluation, and leadership, including annual reviews and involvement in promotions or terminations • Participate in hiring decisions with leadership and Human Resources • Assist with process improvement using lean methodologies and visual boards • Serve as liaison with PacificSource departments and community partners • Serve on internal and external committees as assigned • Promote and utilize evidence-based tools • Maintain a modified caseload • Investigate and resolve process-related issues and facilitate conflict resolution • Oversee and assist with service and information delivery to members, providers, employers, agents, and other customers • Provide backup to departmental teams or management staff • Communicate policy, procedure, and process changes to team members • Facilitate team operations, information sharing, problem-solving, and standardization of Health Services operations • Represent the Health Services Department internally and externally • Perform other duties as assigned
• Minimum of five years clinical experience, including case management experience • Minimum of three years direct health plan experience in case management, utilization management, behavioral health, and/or disease/condition management strongly preferred • Prior supervisory experience preferred • Active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), or Licensed Clinical Social Worker (LCSW) credential required • Certified Case Manager Certification (CCM) accredited by CCMC required at time of hire or within two years of hire date • Knowledge of health insurance and state mandated benefits • Thorough knowledge and experience in case management practice, including advocacy, assessment, planning, communication, education, resource management, and service facilitation • Effective adult education/teaching and/or group leadership skills • Strong analytical and organizational skills • Experience using information systems and computer applications • Ability to develop, review, and evaluate utilization and case management reports • Strong computer skills, including Word, Excel, and PowerPoint • Ability to use audio-visual equipment • Ability to work independently with minimal supervision • Skills in accountable leadership, collaboration, written/verbal communication, critical thinking, decision making, influencing, active listening, and organizational planning • Ability to read and comprehend written and spoken English • Ability to communicate clearly and effectively • Ability to stoop, bend, sit and/or stand for extended periods, and perform repetitive typing, sorting, and filing • Light lifting and carrying of files and business materials • Travel approximately 5% of the time
• Equal opportunity employment • Ergonomically configured equipment • Professional development through orientation, training, coaching, counseling, and ongoing evaluation • Team member support and leadership development • Employment remains at-will
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