Centralized Medical Services - Team Lead, Care Management

ArchWell Health is re-imagining the practice of primary care. We are 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, focused on delivering improved quality, better patient experience and lower total cost of care.

Job Summary

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

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
• Demonstrate 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
• Perform other duties as assigned

Required Skills / Abilities :

Education and Experience :

ArchWell Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.