Lead Case Manager – Specialty Team

Capital District Physicians Health Plan Inc; Town of De Witt (NY); On-site; USD 72,000 - 129,000; Full time

Benefits offered by this job

Group health insurance

Dental insurance

Retirement plan

Wellness program

Paid time away

Paid holidays

Job summary

Capital District Physicians Health Plan Inc seeks a supervisor to lead a team of case managers and clinicians, driving daily operations and strategic initiatives. You will coordinate staffing, training, and performance reviews while representing CM in internal and external meetings.

The role combines people leadership, workflow development, and innovation to shape health plan services and outcomes. Strong leadership and clinical licensure are essential.

Qualifications

• Current New York State clinical licensure in a nursing, behavioral health, physical therapy, NP/PA, or dietitian role with a minimum of three years in case management/quality improvement.
• Knowledge of NCQA, Medicare, and Medicaid guidelines preferred.
• Ability to multitask and balance priorities in a fast-paced health plan environment.
• Proficient computer skills including document creation, Word/Excel, Internet and email.
• Strong leadership, written and verbal communication, problem solving and analytical abilities with all levels of staff.
• For FEP alignment, Case Management Certification required within two years of hire/move into the role.

Responsibilities

• Direct and supervise CM staff, including department function, development plans, performance reviews, and disciplinary actions.
• Coordinate staff communications and daily activities; ensure adequate staffing to meet Health Plan goals.
• Participate in recruitment, training, and retention; verify licenses as applicable.
• Conduct periodic performance reviews, case reviews, and staffing pattern assessments; drive improvements.
• Maintain staff accountability and implement performance management processes.
• Possibly manage a subset of member health programs and coordinate regular team meetings.
• Maintain staff files with annual reviews and mandatory education; prepare reports for Quality Improvement.
• Assist in policy/procedure development for CM and monitor department initiatives.
• Lead new initiatives with project management skills and present area-focused updates.
• Act as liaison with other departments, members, providers, and community agencies.

Skills

Leadership

Communication

Multitasking

Problem solving

Analytical skills

Team coordination

Education

NYS clinical licensure (RN/Behavioral Health Clinician/PT/NP/PA/Dietitian)

Case Management Certification

Tools

Microsoft Word

Excel

Internet/Email

Job description

Capital District Physicians Health Plan Inc seeks a supervisor to lead a team of case managers and clinicians, driving daily operations and strategic initiatives. You will coordinate staffing, training, and performance reviews while representing CM in internal and external meetings.

The role combines people leadership, workflow development, and innovation to shape health plan services and outcomes. Strong leadership and clinical licensure are essential.