Care Management Clinician – Team Lead

Job not on LinkedIn

🔥 13 hours ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $83.2k - $137.3k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

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 Health Plans

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1933

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

PacificSource Health Plans is a healthcare provider that offers a range of health insurance solutions, including plans for individuals, families, and employers. Their offerings include Medicare and Medicaid plans, dental coverage, and administrative services for small and large groups. Committed to member care, PacificSource emphasizes customer service and provides various resources for health management, including mental health support and wellness programs.

📋 Description

• Manage Clinical Care Managers for assigned lines of business • Hire, train, coach, counsel, and evaluate team member performance • Perform routine day-to-day program functions as needed • Participate in program development and implementation • Supervise and guide direct reports and department staff on company policies, procedures, and operations • Manage team task quality, productivity, workflow, and overall Health Services effectiveness • Resolve issues and improve processes and outcomes • Lead development, implementation, operation, and maintenance of assigned programs, services, or functions • Monitor daily workflow, caseloads, 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 • Monitor team assignments for volume, timelines, accuracy, customer service, and quality measures • Support process improvement using lean methodologies, visual boards, and key performance indicators • Liaise with PacificSource departments and community partners to coordinate services and information • Serve on internal and external committees and report pertinent communications • Promote use of evidence-based tools • Maintain a modified caseload • Investigate and resolve process-related issues and facilitate conflict resolution • Oversee and assist with service and information for members, providers, employers, agents, and other customers • Provide backup to departmental teams or management staff • Communicate policy, procedure, and process updates to team members • Facilitate team operations through information sharing, problem-solving, and standardization of Health Services operations • Represent the Health Services Department internally and externally • 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 work 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 • Skills in accountable leadership, collaboration, written/verbal communication, critical thinking, decision making, influencing, active listening, organizational skills, planning and organization • 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 typing/sorting/filing motions, and lift/carry files and business materials

🏖️ Benefits

• Equal opportunity employment • Work inside a general office setting with ergonomically configured equipment • Travel approximately 5% of the time • Company values and culture focused on teamwork, customer service, open communication, community improvement, social justice, equity, diversity and inclusion, creativity, innovation, and excellence