Team Lead, Care Management

Duties/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, and collaborate closely with clinical leadership and operations when there are opportunities for improvement
• Develop and manage team to meet or exceed established goals
• Serve as a role model and function as a clinical resource for the Care Management team
• Supervise and facilitate team development, and oversee the day-to-day tasks/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 effect timely, appropriate member management
• Monitor the quality of RN Care Manager interactions with members, families, physicians, and the multidisciplinary team by regularly shadowing team to ensure clear understanding and adherence to department processes
• Monitor quality of documentation and assessments by regularly auditing the 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 the services delivered
• Adhere to established policy and procedure and standards of care; escalate issues promptly through the established chain of command
• Demonsrate knowledge of regulatory requirements, ArchWell Health compliance policies, and quality initiatives
• Serve as an advocate for members’ rights, needs, and values; ensure that members’ ethnic, cultural, or religious values, beliefs, preferences, and needs are considered and aligned

Required Skills/Abilities

• Ability to travel to visit centers within assigned markets to provide audits, clinical education, and training for members of the clinical team (
• Excellent presentation, verbal, and written communication skills
• Strong interpersonal communication skills with exceptional active listening abilities
• Mission driven and motivated to join an organization that will transform the way we deliver accessible, clinically excellent care to seniors
• Passion for providing care to culturally diverse and medically complex populations and underserved communities

Education and Experience

• Registered Nurse from an accredited college; BSN preferred, with an active Registered Nurse license
• A minimum of 3 years clinical work experience, required
• A minimum of 2 years as a care manager, required
• Previous management experience in a health system, health plan, or other care delivery organization required
• 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