Note: The job is a remote job and is open to candidates in USA. Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. The Supervisor of Care Management provides clinical and administrative leadership to care management teams, overseeing medical and behavioral health clinicians in delivering care management services to members with various health needs.

Responsibilities

Prioritizes daily workflows, assignments, and triage priorities to meet state and Federal regulatory requirements and established organizational performance metrics
Monitors performance and productivity of team and team members to ensure guidelines are followed and goals are met
Facilitates collaboration with internal partners for a coordinated approach to care coordination for members
Supports regionalized care team structure to coordinate care across Integrated Managed Care (IMC) regions
Responsible for a strong understanding of health plan benefits for assigned line(s) of business
Participates in Care Management Rounds to support a productive and collaborative discussion and provide clinical input on cases
Responsible for onboarding new staff and monitoring performance to ensure competency of new skills
Conducts staff audits according to internal policies and procedures to identify opportunities for improvement and alignment with program expectations
Assists in the development of team metrics; implements workflows to achieve assigned metrics. Utilizes data to monitor clinician productivity
Assists management in the identification, implementation, and maintenance of standardized operations to ensure compliance standards are met
Works with management to establish efficiency and quality standards for the team; conducts routine audits and uses data to drive performance improvement
Reviews quality audits and shares results with associates in a timely manner; provides education and coaching to improve performance as needed
Ensures that staff are adequately trained to achieve goals and outcomes for the program. This includes onboarding new staff and ongoing training for existing staff
Assists in performing direct member outreach and care management activities as needed to support staff and the team
Employees are expected to report to work as scheduled, participate in all assigned meetings, and meet established performance and accountability standards
Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion

Skills

Minimum of three (3) years clinical experience in an acute care or public health setting
Minimum of three (3) years as a case manager in an Accountable Care Organization (ACO), Managed Care Organization (MCO), or Behavioral Health Organization (BHO)
Three (3) years supervisory or leadership experience in a healthcare or managed care setting
Bachelor's degree in nursing or a master's degree in social work and/or a related behavior health field
Current, unrestricted RN license in the State of Washington OR a current, unrestricted LICSW license in the State of Washington
Have or will obtain a Case Management Certification within the first two (2) years of employment
Experience with Microsoft Office applications such as Outlook, Word, and Excel
Complete and successfully pass a criminal background check
Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency
Vaccination requirement (CHPW offers a process for medical or religious exemptions)
Three (3) years supervisory or leadership experience in a healthcare or managed care setting

Benefits

10% annual incentive target based on company, department, and individual performance goals
Medical, Prescription, Dental, and Vision
Telehealth app
Flexible Spending Accounts, Health Savings Accounts
Basic Life AD&D, Short and Long-Term Disability
Voluntary Life, Critical Care, and Long-Term Care Insurance
401(k) Retirement and generous employer match
Employee Assistance Program and Mental Fitness app
Financial Coaching, Identity Theft Protection
Time off including PTO accrual starting at 17 days per year.
40 hours Community Service volunteer time
10 standard holidays, 2 floating holidays
Compassion time off, jury duty

Company Overview

For over 30 years, Community Health Plan of Washington (CHPW) has been providing quality health care to Washington families and supporting your choices for health care. It was founded in 1992, and is headquartered in Seattle, Washington, USA, with a workforce of 501-1000 employees. Its website is http://chpw.com/.

Community Health Plan of Washington

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