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HARP Care Manager Team Lead

Job Ref: 60754
Category: Utilization Review and Case Management
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $95,000.00
Salary Range: $95,000.00 - $110,000.00

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. 

Position Overview

Under the supervision of the Behavioral Health HARP Clinical Director, the HARP CM-Team Leader is responsible for the supervision of Care Managers (CM’s) operations within the HARP department. The HARP CM Team Leader monitors the CM departmental ACD phone queue to ensure quality of calls between the care manager, members and providers. The HARP CM Team Lead conducts new hire training and continued training for all clinical staff. The HARP Team Leader participates and interacts with all staff in a supportive role as it relates to care management and coordination daily operations. The HARP Team Leader will enhance communication and processes within the clinical and non-clinical areas within Behavioral Health and between other internal operating departments, to ensure that all member and employee needs are met.

Interviewing now, 2 positions available: 1 with start date in Q2 2021 and 1 with start date in Q4 2021

Job Description

  • Provides guidance to the CM’s within the HARP Department, particularly as it pertains to new processes and workflows which support program operations
  • Promotes and facilitates a multidisciplinary approach, supporting HARP coordinated care operations amongst disciplines. Collaborating as necessary with 
  • HARP UM Team, MetroPlus internal Housing, PIC and ICM programs as necessary
  • Oversee clinical program training/retraining and creation and updating of departmental training tools/workflows and resources
  • Support training for Clinical Care Management processes and protocol in MetroPlus Systems such as Care Connect, DCMS, Cisco, etc.; and all other programs which support HARP BH operations.
  • Oversees and monitors Care Manager’ ACD line activity and reporting. Supervising Crisis Calls and escalating when necessary to HARP Clinical Director.
  • 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
  • Performs quarterly audits of Staff’s chart documentation
  • Works collaboratively with HARP 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
  • Performs all other duties or actions as required under the direction of the HARP Clinical Director

Minimum Qualifications

  • Post graduate clinical experience 6-8 years. At least 3 years previous managed care experience. Ideally 2 years specific to Behavioral Health/HARP.
  • Prior supervisory, training within a management role preferred. (2-4) years
  • Superior Technical Computer skills (Microsoft Office, DCMS, Care Connect, Teams Video Application)
  • Microsoft Excel skills with the ability to edit, search, sort/filter, format/use styles, create tables, calculate data using functions and formulas and create/use PivotTables for analyzing data.
  • Previous Managed Care experience required in Medical Management/HARP Operations
  • and/or Care/Case Management; knowledge of the Collaborative Care Model.
  • Experience with chronic condition management, particularly Diabetes, HIV, Heart Disease
  • Previous authorization experience pertaining to HCBS and Health Home Plans of Care
  • Experience user/reviewer of the HCS/MAPP systems for Health Home member status
  • Excellent written and oral communication skills required. Ability to multi-task well while maintaining a positive “can do” attitude
  • Demonstrated ability to manage large caseloads in a fast-paced environment while building and enhancing team productivity
  • Demonstrated professionalism and leadership skills along with the ability to develop, direct and support staff

Licensure and/or Certification Required

  • LCSW, LMSW, RN, LPN, CASAC, LMHC unrestricted New York State License

Professional Competencies

  • Integrity and Trust
  • Teamwork and Problem-Solving Attitude
  • Customer Focus
  • Functional/Technical Skills
  • Written/Oral Communications
  • Ability to work in a fast-paced environment
  • High degree of diplomacy and tact