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MLTC Care Manager Team Lead

Company: MetroPlus Health Plan
Location: New York
Posted on: August 7, 2022

Job Description:

Empower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.Position OverviewUnder the supervision of the Director of Long Term Care Clinical Programs, the MLTC Care Manager Team Lead is responsible for the supervision of the Care Managers (CM s) operations within the MLTC department. The Care Manager Team Lead monitors the CM departmental ACD phone queue to ensure quality of calls between the care manager, members, and providers. This position also conducts new hire training and continued training for all clinical MLTC staff, participates and interacts with all staff in a supportive role as it relates to care management and coordination daily operations, and enhances communication and processes within the clinical and non-clinical areas within MLTC and between other internal operating departments.Job Description

Provides guidance to the CM s within the MLTC Department, particularly as it pertains to new processes and workflows which support program operationsPromotes and facilitates a multidisciplinary approach, supporting MLTC coordinated care operations amongst disciplinesOversee clinical program training/retraining and creation and updating of departmental training tools and resourcesSME and training expert for Clinical Care Management processes and protocol in MetroPlusHealth Systems such as Care Connect, DCMS, Cisco, etc.; and all other programs which support MLTC operations.Oversees and monitors Care Manager ACD activity and reportingMaintains a tracking tool which logs unacceptable inconsistencies and errors observed during quality reviews of recorded calls via the queue and care management documentation, care planning, follow up and interventionsWorks collaboratively with MLTC management team to ensure program goals, projects and initiatives are implemented and meet departmental workflows and policy standardsSupports Care Management staff as needed when management is in meetings and/or working on other program initiativesAll other duties or actions as required under the direction of the MLTC management teamMinimum Qualifications
  • Bachelor s degree required; BSN preferred3-5 years of experience required in Care Management and/or Managed Care Medicaid/MLTCKnowledge of MLTC program requirements requiredExperience as a user/reviewer of the UAS toolProficiency with healthcare terminology such as ICD-9/10 codes, medical abbreviationsPrior People Leader experience (supervisory or managerial) preferredKnowledge of managed care practices and familiarity with MLTC DOHNYS Registered Nurse (RN) licenseProfessional Competencies
  • Integrity and Trust
  • Customer Focus
  • Functional/Technical skills
  • Written/Oral Communication

Keywords: MetroPlus Health Plan, New York , MLTC Care Manager Team Lead, Executive , New York, New York

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