- Provides guidance to the CM's within the Behavioral Health Mainstream Core Unit, particularly as it pertains to new processes and workflows which support program operations
- Promotes and facilitates a multidisciplinary approach, supporting HARP coordinated care operations amongst disciplines. Collaborating as necessary with both the CORE & HARP Utilization Management Team, and MetroPlusHealth Housing, Partnership In Care, and Integrated Case Management programs as necessary
- Oversees clinical program training/retraining, creation, and updating of departmental training tools/workflows and resources
- Supports training for Clinical Care Management processes and protocols in MetroPlusHealth systems and all other programs which support overall CORE BH operations.
- Oversees and monitors Care Manager' ACD line activity and reporting, supervising Crisis Calls and escalating when necessary to Director of Clinical Case Management
- Maintains a tracking tool which logs unacceptable inconsistencies and errors observed during quality reviews of recorded calls via the queue and care management documentation, care planning, follow-up, and interventions
- Performs quarterly audits of staff chart documentation
- Works collaboratively with HARP management team to ensure program goals, projects and initiatives are implemented and meet BH departmental workflows and policy standards
- Supports Care Management staff as needed when management is in meetings and/or working on other program initiatives
- Performs all other duties or actions as required under the direction of the Director of Clinical Case Management
- Master's Degree required
- Post graduate clinical experience 6-8 years including at least 3 years of managed care experience in medical management or case management. 2 years of experience specific to Behavioral Health preferred
- 2-4 years of supervisory experience and/or training within a management role preferred
- Superior technical computer skills (Microsoft Office, DCMS, Care Connect, Teams Video Application)
- Microsoft Excel skills with the ability to edit, search, sort/filter, format/use styles, create tables, calculate data using functions and formulas, and create/use PivotTables for analyzing data.
- Knowledge of the Collaborative Care Model
- Experience with chronic condition management, particularly Diabetes, HIV, and Heart Disease
- Previous experience pertaining to Health Home Plans of Care
- Experience as user/reviewer of the HCS/MAPP systems for Health Home member status
- LCSW, LMSW, or LMHC unrestricted New York State License
- Integrity and Trust
- Teamwork and Problem-Solving Attitude
- Customer Focus
- Functional/Technical Skills
- Ability to work in a fast-paced environment
- High degree of diplomacy and tact
- Excellent written and oral communication skills required.
- Ability to multi-task well while maintaining a positive "can do" attitude
- Demonstrated ability to manage large caseloads in a fast-paced environment while building and enhancing team productivity
- Demonstrated professionalism and leadership skills along with the ability to develop, direct and support staff
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BH Care Manager Team Lead - New York, United States - MetroPlus Health Plan
Description
BH Care Manager Team Lead
Job Ref:
Category: Utilization Review and Case Management
Department: BEHAVIORAL HEALTH HARP
Location: 50 Water Street, 7th Floor,
New York,
NY 10004
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $92,000.00
Salary Range: $92, $102,000.00
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health + HospitalsMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Position Overview
Under the supervision of the Director of Clinical Case Management in the Behavioral Health HARP department, the Behavioral Health (BH) Care Manager Team Lead is responsible for the supervision of Care Managers (CM) within the BH Mainstream CORE Unit including coordinating daily operations and overseeing case management. The BH CM Team Lead monitors the CM departmental ACD phone queue to ensure quality of calls between the Care Manager, members, and providers. The BH CM Team Lead conducts new hire training and continued training for all clinical staff. The BH CM Team Lead enhances communication and processes within the clinical and non-clinical areas within Behavioral Health and with other internal departments to ensure that all member and employee needs are met.
Job DescriptionLicensure and/or Certification Required:
Professional Competencies: