Job Description
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POSITION SUMMARY / RESPONSIBILITIES
\nProvides supervision to the team which includes case managers, service coordinators, pharmacy technicians, health educators and administrative staff to facilitate compliance with quality and regulatory requirements. Works with all staff within the team to monitor and prioritize work loads, as well as formulate and communicate plans that efficiently utilize health care services in the safest, most cost-effective manner. Monitors and analyzes routine, ad hoc reports, case load, and care coordination management efforts for the team. Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by managing teams which ensure that members have access to all the health care services they need in the most efficient and effective manner possible. Responsibilities include, but are not limited to : overseeing the allocation of resources, cost and quality of health care for members; ensuring the team coordinates care between the primary care physician, community resources, family and member; coordinates care across the health care continuum to include preventive health and social determinants of health efforts while monitoring and managing benefit utilization; and, collaborates with multidisciplinary health care team members in identifying the educational and transition of care needs of members.
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EDUCATION / EXPERIENCE
\nFive years of applicable experience
\nOR five years of applicable experience
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LICENSURE / CERTIFICATION
\nClinicians serving as a supervisor must hold / maintain current licensure requirements in his / her specialty with the State of Texas. All staff serving as a supervisor must maintain a current certification from an appropriate professional agency (such as Case Management Society, Six Sigma, Project Management, etc.) or must be obtained within 24 months of accepting the position.
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Rn Population Health • San Antonio, TX, US