Manager, Care Coordination
1 month ago
Our mission is Better Health. Our passion is helping others.
What's Your Why?
• Are you looking for a career opportunity that will help you grow personally and professionally?
• Do you have a passion for helping others achieve Better Health?
• Are you ready to join a growing team that shares your mission?
Why Join Our Team: At Better Health Group, it's our commitment, our passion, and our culture that sets us apart. Our Team Members make a difference each and every day They support our providers and payors, ensuring they have the necessary tools and resources to always deliver best-in-class healthcare experiences for our patients. We don't just talk the talk - we believe in it and live by it. Be part of a team that shares your passion and drive, and start living your purpose at Better Health Group.
Position Objective:
The Care Coordination Manager oversees and monitors the organization's Care Coordination functions. The goal is to achieve clinical, financial, and utilization goals by focusing on clinical case reviews and audits, clinical program improvements, and quality outcomes (i.e., reduction in emergency room visits and hospital admissions, improved member satisfaction) and cost effectiveness. The Care Coordination Manager manages a clinical team. The incumbent will report to the Vice President, Health Services Operations.
Responsibilities:
Perform routine audits and clinical case reviews for High Cost Cases and for other Programs and summarize findings for meetings with health plan partners and providers
Facilitate and Collaborate in High Cost Review and Other Clinical Program Focused Review Meetings with Chief Medical Officer and other Stakeholders
Lead and mentor a team by providing clinical guidance and supervision to assigned team members in order to promote efficient and effective delivery of services
Conduct regular audits and assessments of team members to ensure quality outcomes
Evaluate and document staff performance; coach staff to improve both quality and quantity of skills attaining optimal performance
Work with the leadership team to develop and implement ongoing training and development
Actively facilitate staff training and meetings
Track, monitor, and communicate trends in Key Performance Indicators and identify drivers and roadblocks to high-quality of care
Collaborate with cross functional teams to identify and resolve challenges and coordinate activities
Resolve issues and mitigate conflict encountered during daily operations; appropriately escalate issues to the Vice President, Health Services Operations
Conduct regular meeting with internal and external stakeholders (e.g., payers, hospitals, SNFs, providers) to discuss program initiatives and progress
Stay updated with industry regulations, guidelines, and best practices to ensure compliance and drive continuous improvement
Utilize data to track, trend and report productivity and outcome measures; work with the management team to implement necessary improvement strategies.
Assist with the preparation of department dashboards and reports
Perform employee performance reviews
Participate in the development and implementation of departmental Playbooks, and monitor/ensure compliance and consistency; review and revise workflows to ensure maximization of resources
Other duties as assigned
Position Requirements/ Skills:
A bachelor's degree in Nursing or related medical field
Proof of successful completion of educational requirements for a Registered Nurse (RN) as defined by the state of Florida, as well as, proof of such licensure in good standing
Licensure to be obtained for additional states or territories as required
3+ years of Care Coordination experience
Complex Case Management (CCM) certification is a plus
Minimum of 2 years leadership/management experience
Proven success working with interdisciplinary teams
Proficient with Google Suite (Drive, Docs, Sheets, Slides) and Microsoft Office (Word, Excel, PowerPoint) for real-time collaboration
Physical Requirements:
Ability to remain in a stationary position, often standing or sitting for prolonged periods of time
Communicating with others to exchange information
Repeating motions that may include the wrist, hands, and/or fingers
Must be able to lift at least 15 lbs at times
Ability to operate a motor vehicle
Key Attributes/ Skills:
Has a contagious and positive work ethic, inspires others, and models the behaviors of core values and guiding principles
An effective team player who contributes valuable ideas and feedback and can be counted on to meet commitments
Is able to work within our Better Health environment by facing tasks and challenges with energy and passion
Pursues activities with focus and drive, defines work in terms of success, and can be counted on to complete goals
Demonstrated ability to handle data with confidentiality
Ability to work cross-functionally with multiple teams; ability to work independently with minimal supervision
Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
Excellent written and verbal communication skills; must be comfortable communicating with senior-level leadership, providers, and health plans
Strong interpersonal and presentation skills
Strong critical thinking and problem-solving skills
Must be results-oriented with a focus on quality execution and delivery
Appreciation of cultural diversity and sensitivity toward target patient populations
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