The Senior Manager, High Acuity Team will be responsible for driving exceptional performance outcomes by fostering a collaborative experience amongst internal and external stakeholders. The role will provide directional oversight to established plans and make adjustments that account for other Multidisciplinary Care Service teams ensuring nationwide alignment. The position will guide and drive the administrative, clinical, and quality activities related to building strong provider and member engagement and health outcomes.
Responsibilities:
Develop and facilitate programs to drive clinical enhancements and a positive team culture
Adjust expectations to meet organizational goals and targets to ensure continuous alignment with mission, vision and values. Reallocating resources to drive accountability where appropriate
Prove to be an exemplary provider to the value-based care team by adjusting team behaviors to accomplish growth targets within the organization
Partner effectively with key stakeholders within operations, sales, data analytics, quality and compliance to improve metrics
Function as ambassador for organization with all internal and external customers
Collaborate as needed with team to help engage providers and members and serve as escalation point for difficult practices and/or members.
Implement organization policies, procedures, workflows, and action plans to drive team performance.
Ensure collaboration and communication among multi-disciplinary teams to ensure they are coordinated in working towards maximum customer engagement and improved member outcomes
Develop, monitor, and report on team performance and productivity
Troubleshoot technical issues within operating systems as identified by team members and establish protocols to correct as appropriate
Promote an environment of continuous improvement through on-going team audits. Work to develop ongoing team education to address areas of opportunity
Develop, coach, and mentor team members to achieve company, department, and individual goals
Conduct regular performance evaluations and provide constructive feedback to redirect team members with a positive discipline approach
Maintain team performance according to National Committee for Quality Assurance (NCQA) standards including but not limited to appropriate provider and member documentation.
Comply with HIPAA privacy laws, all other federal and local regulations, and company security policies
Provide recommendations to the leadership regarding necessary operational adjustments needed to ensure organizational objectives and goals are met
Perform other related duties as assigned
Requirements:
Bachelor’s degree in nursing required; master’s degree preferred
Active RN licensure required
Certified Case Manager (CCM) preferred
Prior experience building and managing relationships with health care providers or patients preferred
Minimum 5 years progressive supervisory and/or management experience required
7 years of experience in healthcare services, clinical operations, quality, or care and utilization management required
Prior experience managing large data sets, demonstrated sales excellence and managing relationships with health care providers or patients
Proof of valid and unrestricted driver’s license required
Skills:
Excellent verbal, written and presentation skills
People skills to develop and maintain strong internal and external relationships
Ability to multitask, prioritize, and create solutions in a challenging environment
Demonstrated leadership skills and ability to create and maintain a positive work environment
Strong critical thinking and analytical skills
Ability to foster strong employee engagement among the team
Must be proficient in Microsoft Office: Outlook, Word, Excel, PowerPoint
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