Medicaid Care Manager Team Lead

4 weeks ago


New York, New York, United States MetroPlusHealth Full time
Job Summary

MetroPlusHealth is seeking a highly skilled Medicaid Care Manager Team Lead to oversee the daily activities of the Medicaid team and ensure quality outcomes in the delivery of member-centered case management. The ideal candidate will have a strong background in care management, clinical guidance, and supervision, as well as experience in workflow management and quality assurance.

Key Responsibilities
  • Provide clinical guidance and supervision to assigned Care Managers and clinical support staff
  • Supervise day-to-day activities to ensure case management services are provided in accordance with clinical guidelines and MetroPlusHealth organizational standards
  • Ensure care management activities are conducted in a safe, efficient, and effective manner to promote continuity and quality of care
  • Review, develop, and modify day-to-day workflows to ensure timely follow-up
  • Evaluate and document staff performance, coach staff to improve quality and quantity of skills
  • Utilize data to track, trend, and report productivity and outcome measures
Requirements
  • Bachelor's Degree required, Master's preferred
  • Minimum of 5 years of Care Management experience in a healthcare and/or Managed Care setting
  • Minimum of 2 years managerial/leadership experience in a Managed Care and/or healthcare setting
  • Proficiency with computers navigating in multiple systems and web-based applications
  • Ability to proficiently read and interpret medical records, claims data, pharmacy and lab reports, and prescriptions
Preferred Qualifications
  • Registered Nurse with a current New York State License
  • Professional Competencies: Integrity and Trust, Customer Focus, Functional/Technical Skills, Confident, Autonomous, Solution Driven, Detail Oriented, Nonjudgmental, Diplomatic, Resourceful, Intuitive, Dedicated, Resilient, and Proactive


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