Manager, Care Coordination

Job Summary

Responsible for leading and directing a team of clinical specialists under the direction of the Director, Case Management for T5 Clinical Operations. The Manager will lead and guide staff in providing integrated services to and for our beneficiaries. Responsible for applying specific guidelines and procedures to apply advanced technical knowledge to solve moderately complex problems. Collaboration with the Director, Case Management to develop care coordination program components to optimize care coordination strategies and goals, and develop and implement policies and procedures.

Education & Experience

Required :

• Bachelor’s degree in Nursing, Healthcare Administration, or related field
• Active, unrestricted license in state of residence if RN / LCSW
• If supporting TRICARE contract, must be a U.S. Citizen
• If supporting TRICARE contract, must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• Minimum of five years managed care experience with progressively responsible management experience in CM or DM operations and program development

Preferred :

Key Responsibilities

Competencies

Coaching / Training / Mentoring : Actively foster actions required for desired business outcomes through ongoing constructive feedback.

Computer Literacy : Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.

Coping / Flexibility : Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required. Easy to do business with across interdepartmental teams, vendors, and clients.

Empathy / Customer Service : Customer-focused behavior; helping approach, including listening skills, patience, respect, and empathy for another's position. Ability to influence or persuade others under positive or negative circumstances.

Independent Thinking / Self-Initiative : Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

Leadership : Successfully manage different styles of employees; provide clear direction and effective coaching. Innovative in problem solving approach and embracing change management.

Multi-Tasking / Time Management : Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.

Organizational Skills : Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented. Ability to function in fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.

Problem Solving / Analysis : Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues.

Team-Building / Team Player : Influence the actions and opinions of others in a positive direction and build group commitment. Successfully manage different styles of employees through effective coaching.

Technical Skills : Knowledge of TRICARE programs or VA Healthcare and benefits, Managed Care, and healthcare principles and delivery systems, URAC national best-practice standards; case management interventions, , crisis intervention strategies, collaboration skills, legal and regulatory requirements, HIPAA privacy regulations, and proficient with Excel, and PowerPoint.

Working Conditions

Working Conditions :