Care Management Clinician – Team Lead

Job not on LinkedIn

🔥 13 hours ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $83.2k - $137.3k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 13%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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PACIFICSOURCE

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1933

Not-for-profit health plans

📋 Description

• Manage Clinical Care Managers for assigned lines of business • Hire, train, coach, counsel, and evaluate team member performance • Lead development, implementation, operation, and maintenance of assigned programs, services, or functions • Monitor daily workflow, caseloads, task distribution, volume, timelines, accuracy, customer service, and performance measures • Provide orientation, ongoing supervision, training, evaluation, and leadership to assigned team members • Participate in hiring decisions with the Director and/or Health Services Manager and Human Resources • Assist with process improvement and interdepartmental processes using lean methodologies and visual boards • Serve as liaison with PacificSource departments and community partners • Serve on internal and external committees as required • Utilize and promote evidence-based tools • Maintain a modified caseload • Facilitate investigation and resolution of process-related issues and conflicts • 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 policies, procedures, and processes to team members • Facilitate team operations through information sharing, problem-solving recommendations, and standardization of Health Services operations • Represent the Health Services Department internally and externally • Meet department and company performance and attendance expectations • Perform other duties as assigned

🎯 Requirements

• 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 • Ability to deal effectively with people who have various health issues and concerns • Strong analytical and organizational skills with 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 • Ability to read and comprehend written and spoken English • Ability to communicate clearly and effectively • Ability to stoop and bend, sit and/or stand for extended periods, perform repetitive motions, and lift/carry files and business materials

🏖️ Benefits

• Equal opportunity employment • Ergonomically configured equipment • Professional development through orientation, training, coaching, and ongoing leadership • Work-from-home arrangement • Paid travel for approximately 5% of work time