Care Manager Team Leader
Job Ref: 63572
Category: Utilization Review and Case Management
Department: MANAGED LONG TERM CARE
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Salary Range: $95,000.00 - $104,064.00
About NYC Health + Hospitals
MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Under the supervision of the MLTC Clinical Program Manager, the Care Manager Team Leader is responsible for the supervision of the Care Managers (CM’s) operations within the MLTC department. The Care Manager Team Leader monitors the CM departmental ACD phone queue to ensure quality of calls between the care manager, members and providers. The Team Lead conducts new hire training and continued training for all clinical MLTC staff. The Team Leader participates and interacts with all staff in a supportive role as it relates to care management and coordination daily operations. The Team Leader will enhance communication and processes within the clinical and non-clinical areas within MLTC and between other internal operating departments.
Salary commensurate with experience and education
- Provides guidance to the CM’s within the MLTC Department, particularly as it pertains to new processes and workflows which support program operations
- Promotes and facilitates a multidisciplinary approach, supporting MLTC coordinated care operations amongst disciplines.
- Oversee clinical program training/retraining and creation and updating of departmental training tools and resources.
- SME and training expert for Clinical Care Management processes and protocol in MetroPlus Systems such as Care Connect, DCMS, Cisco, etc.; and all other programs which support MLTC operations.
- Oversees and monitors Care Manager’s ACD activity and reporting.
- Maintains a tracking tool which logs unacceptable inconsistencies and errors observed during quality reviews of recorded calls via the queue and care management documentation, care planning, follow up and interventions
- Works collaboratively with MLTC management team to ensure program goals, projects and initiatives are implemented and meet departmental workflows and policy standards
- Supports Care Management staff as needed when management is in meetings and/or working on other program initiatives
- All other duties or actions as required under the direction of the MLTC management team.
- Registered Nurse, current New York State license, Bachelor’s degree (BSN) preferred.
- Previous Managed Care experience required in Medical Management Operations and/or Care/Case Management.
- Knowledge of MLTC program requirements required.
- Experience user/reviewer of the UAS tool.
- Prior supervisory or managerial experience preferred.
- Excellent communication, interpersonal, written and analytical skills.
- Integrity and Trust
- Customer Service Focus
- Functional/Technical skills
- Written/Oral Communications