Supervisor, Care Management Coordinator

Job Summary

The Supervisor of Care Management Coordinator is responsible for direct supervision and support of the team responsible for the outreach, intake, member coordination, case tracking, trending and reporting within the Care Management department. This position is accountable for leading and directing the work for the Care Coordination team by monitoring the outreach, member coordination, and communications as outlined in the state and federal regulations and company policies and procedures. The Supervisor provides support and ownership of cases identified as escalated on an as needed basis. This position collaborates with internal departments to ensure timely resolution. This position will be responsible for analyzing,  trending, and ensuring assignment of all high risk and complex care management cases. Responsible for the development and maintenance of the care management procedures, workflows, member correspondence, and training as needed, or on an annual basis.

The position supervises all aspects of running an efficient  team, including hiring, supervising, coaching, training, disciplining, and motivating direct-reports.
 

Duties

Evaluates daily reports to ensure individual and team Key Performance Indicators (KPIs), SLAs, Performance Scorecards meet regulatory requirements.

Provide direction to staff for member and provider inquiries, concerns, complaints and coordination needs. Conduct weekly 1:1s with direct reports.                                                                                                                                                                 
Monitors and organizes staffing coverage to ensure operational effectiveness 

Builds and maintains strong working relationships with internal departments and external stakeholders involved in the coordination of care for high risk and complex members.

Development, maintenance and implementation of P&Ps, workflow and training.                                                                     
Staff performance oversight including case reviews and audits, and monitoring productivity                                                     
Lead and participate in team meetings

Audit preparation and providing recommendations for Corrective Action Plans from state regulatory agencies.

Responsible for the daily workflow and leading the work of assigned staff.  This role will mentor, coach, act as a resource and provide feedback on performance of assigned staff.

Performs other duties as assigned.

Duties Continued

Education Required

Education Preferred

Experience

Required:
Minimum 0-2 years of experience in a healthcare or managed care setting, case management, authorization processes and/or claims with 1-2 years of lead/supervisory experience.

Equivalency:  Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement.

Preferred:
Previous experience in Managed Care preferably in Customer Service, Care Management, Appeals and Grievances and/or Claims.
Participated in a 2-year management mentoring program
 

Skills

Required:
Ability to manage and organize large volumes of data.

Knowledge of regulatory and accreditation entities and their requirements.

Excellent verbal and written communication skills and interpersonal skills.

Good working knowledge of licensure and regulatory requirements, and accreditation standards.

Ability to work independently.

Ability to solve complex issues and identify creative solutions.

Microsoft Office (Word, Excel, Power Point, Access, and Visio).

Preferred:
Knowledge of L.A. Care core computer system

Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.
 

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Preferred:
Motivation Interviewing 

Trauma Informed Care

Physical Requirements

Additional Information