Team Lead, Care Management

About the Role

ArchWell Health is re-imagining the practice of primary care by putting the relationship between patient and physician at the center of a value-based model focused on outstanding patient experience, improved access, and better outcomes. In our medical clinics, we provide comprehensive primary care for senior adults with traditional Medicare and Medicare Advantage plans, delivering improved quality, better patient experience, and lower total cost of care.

The Care Management Team Lead will be an integral part of the clinical leadership team, responsible for recruiting, onboarding, leading, and performance managing Care Managers who support transitions of care and management of high-risk individuals in multiple markets and states, within an outpatient geriatric primary care setting. This role provides leadership oversight and support for clinical utilization to drive improvement of value-based care.

Responsibilities

• Lead a team of remote and/or market-based RN Care Managers and support staff, including interviewing, hiring, training, market support, and colleague coaching and development.
• Analyze quality performance at the center and market level, collaborating closely with clinical leadership and operations to identify and address opportunities for improvement.
• Develop and manage the team to meet or exceed established goals.
• Serve as a role model and clinical resource for the Care Management team.
• Supervise and facilitate team development, overseeing day-to-day tasks and activities in the department.
• Ensure team members are competent in the use of EMR (eCW), care management platform, and other online tools.
• Work collaboratively and maintain active communication with providers, nurses, and other members of the multidisciplinary care team to ensure timely, appropriate member management.
• Monitor the quality of RN Care Manager interactions with members, families, physicians, and the multidisciplinary team by regularly shadowing the team to ensure adherence to department processes.
• Monitor the quality of documentation and assessments by regularly auditing RN Care Managers’ documentation.
• Participate in clinical performance improvement activities.
• Complete daily, weekly, and monthly reports as assigned by leadership.
• Seek ways to control costs without compromising member safety, quality of care, or services delivered.
• Adhere to established policy and procedure and standards of care; escalate issues promptly through the established chain of command.
• Demonstrate knowledge of regulatory requirements, ArchWell Health compliance policies, and quality initiatives.
• Serve as an advocate for members’ rights, needs, and values, ensuring alignment with their ethnic, cultural, or religious values, beliefs, preferences, and needs.
• Perform other duties as assigned.

Requirements

• Ability to travel to visit centers within assigned markets to provide audits, clinical education, and training for members of the clinical team (<20% travel).
• Excellent presentation, verbal, and written communication skills.
• Strong interpersonal communication skills with exceptional active listening abilities.
• Mission-driven and motivated to join an organization transforming the delivery of accessible, clinically excellent care to seniors.
• Passion for providing care to culturally diverse and medically complex populations and underserved communities.

Qualifications

• Registered Nurse from an accredited college; BSN preferred, with an active Registered Nurse license.
• A minimum of 3 years of clinical work experience.
• A minimum of 2 years as a care manager.
• Previous management experience in a health system, health plan, or other care delivery organization.
• Experience managing a remote team highly preferred.
• Certified Case Manager certification through the Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) highly desired.
• Managed care experience, including knowledge of HEDIS and CMS guidelines.
• Willingness and ability to maintain current and new licensure or certification requirements as mandated by state regulations.