• Supervisor, Care Coordination

    Job Locations US-VA-Chesapeake
    Job ID
    2018-4936
  • About Us

    Don’t just find a job, find your WHY at a purpose-driven organization; discover a career at Virginia Premier.
    By blending quality benefits, affiliating with the world-renowned VCU Health System and offering career-advancing development programs, we allow our employees to focus on the meaningful work of improving and saving the lives of more than 200,000 people throughout the state of Virginia.
     
    At Virginia Premier, we are building an industry leading health care organization through dedicated teams that have heart, provide top-notch quality member services and embrace our mission of inspiring healthy living within the communities we serve. Our vision is to connect people to innovation, quality and affordable health care for all phases of life.
     
    If this sounds like you, read on!

    Overview

    This position is responsible for supervising MLTSS care coordination staff, providing daily oversight of all care coordination activities performed by staff, and supporting leadership in MLTSS program enhancements.

    Responsibilities

    • Supervises day-to-day model of care (MOC) activities performed by staff for the MLTSS program including assessments, individualized care plans, interdisciplinary care team meetings, transitions, and care coordination.
    • Maintains appropriate staffing levels and assignments to ensure excellent customer service and meet regulatory timeframes.
    • Works with care coordination staff to provide guidance and/or intervention in problematic/unusual cases
    • Assists with onboarding new staff and ongoing mentoring/coaching of care coordinator staff
    • Serves in an advisory capacity for problem solving, reviewing reports being sent to internal and external customers, reviewing problematic cases, and monitor medical management activities in collaboration with the manager
    • Maintains resources, keeping information up-to-date
    • Supports Manager in ongoing quality improvement initiatives by assisting with various quality review tasks such as collecting and analyzing data as outlined in the program
    • Participates in assigned VPHP meetings to educate providers and/or members (which may occur outside of normal business hours)
    • Provides Manager with documentation on individual team members’ performance on a regular basis
    • Performs annual/interim appraisals of care coordinator staff as assigned
    • Collaborates with the Manager and Human Resources team develop, implement, and monitor corrective action plans for staff as appropriate
    • Assists in the ongoing development of programs and care coordination projects to enhance/expand the department
    • Maintains confidentiality of patient information, and VPHP proprietary operational information
    • Maintains current knowledge of VPHP policies and procedures
    • Participates in continuing education activities as appropriate
    • Participate in quality audits; ensuring staff is meeting quality and productivity metric

    Qualifications

    EDUCATION/CERTIFICATION REQUIREMENTS

    • Registered Nurse licensed to practice nursing in Virginia; or
    • Licensed Clinical Social Worker; or
    • Licensed Mental Health Professional
    • Certified Case Manager (CCM) is a plus
    • Minimum of 1 year supervisory experience

    SPECIAL KNOWLEDGE AND/OR SKILLS

    • Strong oral and written communication skills
    • Knowledge of community resources and vendor options and experience in making appropriate referrals
    • Possess knowledge of Medicare and Medicaid programs
    • Ability to communicate effectively with individuals who have complex medical and/or behavioral health needs
    • Proficiency in Microsoft Office applications (Excel, PP, Word)

    WORK BACKGROUND/EXPERIENCE

    • Minimum of 1 year working experience in a long term care, home health, public health, behavioral health, or Medicaid managed care setting
    • Experience working with low-income, disadvantaged, disabled, elderly, and vulnerable populations
    • Experience working with low-income, disadvantaged, disabled, elderly, and vulnerable populations

    PHYSICAL REQUIREMENTS

    • Physical health sufficient to meet the ergonomic standards and demands of the position 

    All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

     

    Our mission is to inspire healthy living within the communities we serve!

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