Care Management Clinician – Team Lead

This is a fully remote position, open to applicants in Montana.

📋 Description

• Oversee Clinical Care Managers within designated business lines

• Recruit, train, mentor, guide, and assess team member performance

• Spearhead the development, execution, operation, and upkeep of assigned programs and services

• Supervise daily workflow, caseloads, task allocation, volume, timelines, accuracy, customer service, and performance metrics

• Provide orientation, continuous supervision, training, assessment, and leadership to designated team members

• Involve in recruitment decisions alongside the Director and/or Health Services Manager and Human Resources

• Contribute to process enhancement through lean methodologies and visual boards to track key performance indicators

• Collaborate with PacificSource departments and community partners to enhance service and information delivery

• Participate in internal and external committees and relay relevant information to the team or department

• Utilize and advocate for evidence-based tools

• Manage a modified caseload

• Investigate and address process-related challenges and facilitate conflict resolution

• Supervise and assist with service and information for members, providers, employers, agents, and other stakeholders

• Provide support to departmental teams or management staff as necessary

• Communicate updated policies, procedures, and processes to team members

• Enhance team operations through information sharing, problem-solving suggestions, and standardization of Health Services operations

• Represent the Health Services Department both internally and externally as required

• Carry out additional responsibilities as assigned

⛳️ Requirements

• A minimum of five years of clinical experience, including case management experience

• At least three years of direct health plan experience in case management, utilization management, behavioral health, and/or disease/condition management is strongly preferred

• Prior supervisory experience is preferred

• An active, unrestricted RN, LPC, LMFT, or LCSW credential is required

• Certification as a Case Manager (CCM) accredited by CCMC is required by the time of hire or within two years of the hire date

• Understanding of health insurance and state-mandated benefits

• Comprehensive knowledge and experience in case management practices, including advocacy, assessment, planning, communication, education, resource management, and service facilitation

• Proficient adult education/teaching and/or group leadership skills

• Strong analytical and organizational abilities

• Experience with information systems and computer applications

• Capability to develop, review, and assess utilization and case management reports

• Strong computer proficiency, including Word, Excel, and PowerPoint

• Ability to operate audio-visual equipment

• Capacity to work independently with minimal supervision

• Proficient in reading and comprehending written and spoken English

• Ability to communicate clearly and effectively

• Ability to stoop and bend, sit and/or stand for extended periods, perform repetitive typing/sorting/filing, and lift/carry files and business materials

🏝️ Benefits

• Flexible work-from-home arrangement in Montana

• Travel required approximately 5% of the time

• Commitment to equal opportunity employment

• Employment is at-will