As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
Team leaders maintain an active and aggressive role in interfacing with participants and participant circumstances. This includes both direct participant contact and supervision of nurses who perform direct participant services. IMMS team leaders maintain their own participants as well as supervising other nurses in the performance of their roles. The Team Leaders take leadership roles in coordinating overall plan performance on behalf of the clients for whom InforMed and IMMS provide services. The Team Leaders are involved in orchestrating the clinical interactions with the customers and facilitating clinical integration with the account managers. The Team Leader oversees the case management staff, thus ensuring that the staff provides quality service to participants and clients, that the staff has resources and training, that there is appropriate case load management and that the case managers fulfill their financial responsibilities in management of participants and clients. Additionally, Team Leaders are in constant contact with the â��realâ�� part of the profession of nursing and are directly involved in client relations.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
Daily Management of Team: Motivates the team to function cohesively, Effects change within the team, Communicates management issues to team, Communicates team issues to upper management, Plans and participates staff meetings and trainings, Acts as a resource to the nurses, Manages PTO and coverage of team members, Provides backup coverage with account meetings and interactions should the case manager not be available
Ongoing Management of Team: Completes and delivers performance evaluations, Reviews the quality reports, Reviews and addresses the team members â��performanceâ�� scores, Identifies training needs, Identifies external educational opportunities, Provides positive feedback formally and informally, Conducting and delivering new employee and annual evaluations utilizing IMMS System Reports and Quality Reviews, Completing Quality Training Reviews, Adheres to the InforMed Corrective Discipline process, Annual reviews of education requirements and conduct
Interacts directly with participants, Meets â��Satisfactoryâ�� or above on all case management performance indicators,
Consults with IMMS Medical Director on issues of concern about participant treatment plans, Reviews and addresses outcomes accessible through the Outcomes report. Ensures that all â��High Risk Stratâ�� participants are screened and opened for ongoing Med Mgt if appropriate
Uses MMOTS to document analytic time, Uses MMOTS reports as tools to provide ongoing training and orientation, Manages caseloads through MMOTS case load management tool, Uses MMOTS reports as tools for team management and account management
Reviews and addresses the management of the referral process
Account Management: Manages/assists team memberâ��s management of accounts using the â��4-Prongedâ�� approach. Provides leadership in the implementation of new customer. Participates and/or assists team members in active participation in account meetings. Educating the case managers about the requirements specific to for the accounts they serve
If direct report positions are listed below, the following responsibilities will be performed in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
Direct Reports (titles) N/A
Indirect Reports (titles) N/A
KNOWLEDGE, SKILLS, ABILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Competency in Microsoft Word, using email and attachments
Excellent verbal communication skills with the ability to communicate with participants and communicate professionally with individuals who serve in a variety of functions, i.e. physicians, account managers, brokers, customer service staff, IMMS executive management, other case managers, hospital utilization review nurses, etc.
Excellent written communication skills with the ability to write in a professional, business manner
Ability to analyze and resolve complex problems
Team leading abilities: resolve team conflicts, lead a diverse group of individuals, effect change in others, motivate a group of individuals to function as a team
Excellent organizational, prioritization, and time management skills
Ability to make logical and objective decisions
Ability and willingness to function independently
Flexibility and willingness to change
Understanding of the CMSA Standards of Practice
Understanding of IMMS holistic approach to medical management
Understanding of the clientâ��s (customerâ��s) perspective and needs
Understanding of legislative acts, such as the ADA, ERISA
Understanding of CMSA Standards of Practice and Professional Code of Ethics
EDUCATION / EXPERIENCE
Include minimum education, technical training, and/or experience preferred to perform the job.
A Bachelor of Nursing degree and licensure as a registered nurse in state of residence with eligibility for unrestricted licensure in all states, or
Certification as a case manager and licensure as a registered nurse in state of residence with eligibility for unrestricted licensure in all states.
Certification in Case Management is required of Team Leaders who have directly supervised the case management process for three or more years.
A Bachelor of Nursing degree
Five (5) years of UM/CM experience
Certified Case Manager (CCM)
Registered Nurse licensure in all states where contracts are held
Three to five (3-5) years of diverse clinical experience
Two to three (2-3) years of managerial experience
Include minimum certification required to perform the job.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Must be able to work in sitting position, use computer and answer telephone
Ability to travel
Job: Conifer Health Solutions
Primary Location: Texas
Facility: InforMed Med Mgmt Services
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.