Care Coordination Sr. Manager

Found in: Appcast Linkedin GBL C2 - 2 weeks ago

Minneapolis, United States UCare Full time

Work Location: Office for your Day


Position Description

As the Care Coordination Senior Manager – MSHO/MSC+, your primary responsibilities will be for the management of UCare’s Minnesota Senior Health Options (MSHO) and the Minnesota Senior Care Plus (MSC+) care coordination team. This position will set priorities for the team to ensure that assigned job duties are completed and to oversee process improvement strategies, organizational goals, regulatory guidance and data based on the MSHO/MSC+ models. This position will provide direct supervision, mentoring, coaching and evaluation of the MSHO/MSC+ supervisor’s performance and development needs. In addition, this position will oversee the planning, implementation, and evaluation of care coordination activities to ensure departmental, contractual, and regulatory requirements are met. The manager will also collaborate cross departmentally to assist with complex cases.


  • Oversee teams’ performance of care coordination and Associate Care Coordination activities including compliance with all contractual obligations.


  • Monitor delivery of care coordination services. Review and evaluate care coordination staff documentation of assessments, care plans, and care coordination activities, audit member records, monitor staff productivity, identify system barriers and possible solutions.


  • Oversee the MSHO/MSC+ care coordination supervisors to ensure proper staff supervision is in place. In the absence of care coordination supervisor, assigns and allocates workload to care coordinators. Ensure timely assessment and reassessments of cases. Oversee tracking and trending of productivity for the team.


  • Work collaboratively with the Clinical Liaison’s and provide clinical consultation for internally managed members.


  • Assist with the oversight of regulatory reporting for MSHO products: support other MSHO leaders in the completion of the annual Model of Care Evaluation, work with the Compliance Department and Government Relations on annual DHS reporting, assist the Care Coordination Associate Director with writing and submitting the Model of Care to CMS. Prepare and submit regulatory findings to stakeholders as needed.


  • Develops tools and resources to assist the care coordinators in performing their duties, including assessments, care plans, training opportunities and algorithms for commonly occurring medical and social complexities in the population.


  • Provide leadership and guidance related to overall enhancements and changes to the program as directed by CMS, DHS, and/or internal UCare changes. This may include such things as working together to provide complex care coordination for members who may have unique needs for support in their utilization of the health care system, and strategizing about member specific interventions, and facilitation of same.


  • Chair care coordination review meetings in conjunction with the care coordination supervisors. Provides clinical consultation to UCare staff in resolving complex cases.


  • Lead team meetings in conjunction with the Supervisors.


  • Participate in the development of departmental policies and procedures for the MSHO/MSC+ program.


  • Participate in meetings as assigned by the SNP Care Coordination Associate Director.


  • Recruit, interview and select new staff.


  • Prepare monthly reports of activities and identifies opportunities to increase efficiencies, productivity, and quality of work.


  • Provide back-up support for Care Coordinators with in-person and telephonic assessments as appropriate.


  • Must have reliable transportation to travel throughout designated counties in Minnesota.


  • Other projects and duties as assigned.


Education

Bachelor’s degree in Nursing, Social Work or other related field. Current unrestricted Minnesota license.


Required Experience

Five years supervisory or management experience in a health plan, managed care organization, or clinical setting. 2-3 years of care coordination and/or case management experience. Experience with program performance measurement, data, reporting, and analysis. Knowledge of State and Federal regulations, experience with national accreditation standards.


MnCHOICES certified assessor credential in place or plan to receive assessor credential within 3 months of hire date.


Preferred Experience

Experience in working with Medicaid and Medicare programs, particularly with UCare products.

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