Care Management Clinician – Team Lead

Job not on LinkedIn

🕒 5 days ago

🦬 Montana – Remote

🦬 Montana – Remote

💵 $83.2k - $137.3k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 20%

What it means: the chance that no one is really hiring for this job.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 across assigned lines of business • Hire, train, coach, counsel, and evaluate team member performance • Lead development, implementation, operation, and maintenance of assigned programs and services • 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 using lean methodologies and visual boards to monitor key performance indicators • Coordinate with PacificSource departments and community partners to optimize service and information delivery • Serve on internal and external committees and communicate pertinent information to the team or department • Utilize and promote 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 as needed • Communicate updated 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 as requested • Perform other duties as assigned

🎯 Requirements

• Minimum of five years of clinical experience, including case management experience • Minimum of three years of direct health plan experience in case management, utilization management, behavioral health, and/or disease/condition management strongly preferred • Prior supervisory experience preferred • Active, unrestricted RN, LPC, LMFT, or LCSW credential required • Certified Case Manager (CCM) certification 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 • 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, and lift/carry files and business materials

🏖️ Benefits

• Work-from-home arrangement in Montana • Travel approximately 5% of the time • Equal opportunity employment • At-will employment

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