Care Management Clinician – Team Lead

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🔥 1 minute ago

🦬 Montana – Remote

🦬 Montana – Remote

💵 $83.2k - $137.3k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

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

• Lead the development, implementation, operation, and maintenance of assigned programs, services, or functions • Manage, supervise, train, coach, counsel, and evaluate Clinical Care Managers and other assigned staff • Monitor daily workflow, caseloads, task distribution, timelines, accuracy, customer service, and performance measures • Participate in hiring decisions, promotions, terminations, orientation, and training of employees • Improve department performance, processes, and outcomes using lean methodologies and visual boards • Serve as liaison with PacificSource departments and community partners to coordinate services and information • Participate in internal and external committees and communicate pertinent information to teams • 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 policy, procedure, and process updates to team members • 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 required • 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 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, bend, sit and/or stand for extended periods, and perform repetitive motions; light lifting and carrying

🏖️ Benefits

• Equal opportunity employment • Approximately 5% travel • Ergonomically configured equipment • Training and professional development through orientation, ongoing training, and coaching