Supervisor, Care Coordinator - Phoenix, United States - TriWest Healthcare Alliance

TriWest Healthcare Alliance

Verified Company

Phoenix, United States

2 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Profile:

Veterans, Reservists, Guardsmen and military family members are encouraged to apply

We offer remote work opportunities (AK, AR, AZ, CA, *CO, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, ND, OK, OR, SD, TX, UT, WI & WY only)

Job Summary
Supervises daily operations of care coordination services and staff. Ensures staff is fully-informed of changes impacting their work by communicating updates, policy revisions, performance outcomes, and significant events. Advises non-clinical staff regarding support tasks.

Supervisors are responsible for reviewing and understanding the scope of practice of their state of licensure as well as those of associated staff.

Education & Experience

Required:

Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW), with a current unrestricted license, with one (1) year supervisory experience or equivalent leadership role, and,
U.S. Citizenship
Case Manager Certification by a URACrecognized entity
Three years fulltime equivalent of direct clinical care to the consumer
Two Years Case Management or equivalent experience

Preferred:

Bachelor's degree or higher in healthrelated field
Experience in the TRICARE benefit program or the Military Health System

Key Responsibilities

Supervises the daily operations of case management services. Hires, trains, coaches, counsels, and develops clinical and nonclinical staff. Supports recruitment efforts by interviewing, selecting, and training new staff.
Applies knowledge of HIPAA privacy and security regulations as well as URAC accreditation standards to ensure compliance in daily practice.
Coordinates staff orientation and training. Ensures staff provides case management within scope of practice and in compliance with organizational protocols, desk procedures, and policies. Provides staff training, including training aids. Documents and assesses effectiveness of staff training.
Supervises individual staff caseload and beneficiary treatment plans to ensure delivery of care, productivity, and timeliness. Evaluates case manager practice for quality, timeliness, and process consistency. Conducts regular and ad hoc case review audits, providing staff feedback regarding results and process improvement. Participates in the evaluation of the case management program.
Ensures compliance with TriWest policy and Health Care Services desk procedures.
Collaborates with case managers, care coordinators, medical providers, the Director, Case Management and the Medical Director for Case Management on program interpretation and guidance.
Actively participates in clinical and nonclinical performance improvement projects and meetings.
Monitors and provides input on the performance of nonclinical staff.
Supports department by covering case management and CM Special Programs, and/or carry a case load as necessary.
Performs other duties as assigned.
Regular and reliable attendance is required.

Competencies

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

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

Organizational Skills:
Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented

Problem Solving / Analysis:

Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues, tactics, and strategies.

Team-Building / Team Player:
Influence the actions and opinions of others in a positive direction and build group commitment.

Technical Skills:

Thorough knowledge of TRICARE policies and procedures, Case Management, Utilization Management, HIPAA Privacy and Security regulations, URAC accreditation standards, Managed Care concepts, Behavioral Health practices and principles, community resources, alternative funding programs, medical management systems.

Proficiency with International Classification of Diseases, Current Procedural Terminology, Healthcare Common Procedural Coding System.

Working Conditions

Working Conditions:

Availability to cover any work shift
Works within a standard office environment, with mínimal travel
Extensive computer work with prolonged sitting

Company Overview:

Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do.
Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team We're On a Mission to Serve
Our job is to make sure that America's heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.

Benefits:

We're more than just a health care company. We're passionate about