RN Care Management Clinical Team Lead - Los Angeles, CA - Hybrid

About the role

The Clinical Team Lead provides operational support to managers and supervisors for the assigned program. This role is an individual contributor and assignments are highly dependent on operational needs and priorities.

Responsibilities

• Onboard new teammates and provide training for the assigned work during the probationary period.
• Collaborate with the management team to provide ongoing training to teammates identified through quality auditing where opportunities are identified to improve performance or productivity.
• Develop and provide training to teams for all new, updated processes and workflows. Training attendance will be documented and submitted with the Operational Support team.
• Manage patient and provider escalations or grievances by providing research into the inquiry and provide a summary to the leadership for actions needed.
• Manage health plan escalations in collaboration with the delegation oversight team.
• Develop and maintain all job aids that support system and processes for the assigned team.
• Support for organizational realignment and change management by providing training, document updates and communication.
• Support resource planning and allocation by reviewing daily assignments, shifting resource assignments when necessary to manage daily workloads.
• Teammate scheduling when applicable.
• Internal messaging and communication on upcoming changes and plans for operational readiness related to membership, programs, regulations or health plan changes.
• Technology training and change readiness monitoring in support of system modifications.
• Post implementation program/process monitoring and re-training to assure quality and performance meet team goals.
• Works with teams to bring forward patients for IDT collaboration.
• Maintains team caseloads and productivity and makes recommendations to leadership for workforce management.

Professional Competencies

• Demonstrate knowledge of PC applications including MS Office Suite.
• Able to use written and oral communication skills.
• Able to read and interpret data.
• Skill in writing clear, grammatically correct, easy-to-use instructional documentation.
• Able to identify learning needs, set goals and seek educational opportunities.
• Able to analyze problems and formulate appropriate plans, solutions and courses of action.
• Knowledge of age specific communication is needed with the ability to listen actively and respond to internal and external customers in a timely, competent manner both verbally and nonverbally.
• Able to work with frequent interruptions.
• Able to establish and maintain cooperative working relationships with individuals at all levels of the organization and affiliates.
• Able to maintain confidentiality of patient and all related entity business matters of the organization and its partners.
• Able to manage detail and work with accuracy.
• Able to recognize and act appropriately in situations where patient care needs exceed medical certification.
• Skill in working with a team; ability to collaborate on projects with colleagues.
• Able to work effectively under deadlines and changing priorities.

Skills

• All staff members are to promote a positive and productive work environment by acting maturely and responsibly, satisfactorily performing his or her job responsibilities and conducting themselves in a professional, courteous, and respectful manner toward fellow employees, physicians and patients.
• Integrates Lean principles, practices, and tools to improve operational efficiency, reduce costs and increase customer satisfaction.
• Perform all duties in a manner which promotes and supports the Core Values and Mission Statement.
• Work as an interdisciplinary team member with members, physicians, administration, staff and other managers.
• Frequently follow written and oral instructions and complete routine tasks independently.
• Ensures confidentiality of patient information following HIPAA guidelines and company policies.
• Attends/completes training to meet requirements of the job position and as needed or mandated by company policies and regulations.
• Has regular and predictable attendance.

Qualifications

• Associate's Degree in related clinical field from an accredited college.
• Current, unrestricted California RN license.
• 3+ years of broad-based clinical experience and an expert in their respected function.
• Acute inpatient experience preferred.