Medicare Integrated Care Management Supervisor (RN or LCSW)

Health Plan of San Mateo (HPSM); South San Francisco (CA); Sur place; USD 120 000 - 160 000; Plein temps

Résumé du poste

The Health Plan of San Mateo (HPSM) seeks a Supervisor, Integrated Care Management to provide clinical and operational oversight of a multidisciplinary care team in our California program. The role ensures seamless transitions between levels of care and supports the department's performance metrics.

The ideal candidate holds a CA RN or LCSW license, with a master’s in a related field preferred, and at least three years in care management including supervisory experience.

Qualifications

• Bachelor’s degree in nursing, psychology, or social work; master’s preferred.
• Three years of care management experience.
• At least one year of supervisory experience in health care or managed care.

Responsabilités

• Lead a self-accountable multidisciplinary team and promote accountability.
• Develop and monitor department budget and ensure resource efficiency.
• Supervise care management services and optimize workflows.
• Facilitate IDTs, case conferences, and team huddles.
• Maintain licensure and promote holistic, member-centric care.

Connaissances

Supervision

Care management

Organizational skills

Interpersonal skills

Team leadership

Formation

Bachelor’s degree in nursing, psychology, or social work

Master’s degree preferred

Outils

Microsoft Office

Outlook

Excel

Teams

Description du poste

RN or LCSW licensure is required General Description The Supervisor, Integrated Care Management is responsible for providing clinical and operational oversight of a multidisciplinary care team. The supervisor ensures effective coordination with other supervisory staff to support seamless transitions between levels of care for members and contributes to the development of a cohesive and high-performing unit and is accountable for meeting established productivity and quality standards with accuracy to achieve the Health Services department's overall performance metrics. This position reports to the Manager, Integrated Care Management. Qualifications The following represents the typical way to achieve the necessary skills, knowledge, and ability to qualify for this position: Education and Experience

• Bachelor’s degree in nursing, psychology, or social work (master’s preferred), with three (3) years of care management experience and at least one (1) year of supervisory experience in a health care or managed care setting preferred. Skills
• Advanced organizational and time management skills, combined with ability to provide supervision, guidance, and support to a multidisciplinary team.
• Intermediate Microsoft Office Suite application skills, (e.g., Outlook, Word, Excel, Teams, Visio, and PowerPoint.)
• Intermediate skills in developing and maintaining effective interpersonal relationships with providers, members, community partners, public agencies, and government programs. Knowledge
• Extensive knowledge of health care and/or community case management models.
• Working knowledge of Medicare and Medi-Cal regulations and requirements related to care coordination, case management, transitions of care, and documentation standards.
• Working knowledge of compliance standards in CMS, NCQA, DHCS, CalAIM, HIPAA and organizational care management. Abilities
• Demonstrated ability to lead and collaborate effectively with diverse teams and partners to achieve outcomes.
• Demonstrated ability to interpret clinical information and support staff in applying evidence based care management approaches.
• Ability to use care management platforms and electronic documentation systems to guide staff and monitor performance.
• Demonstrated ability to support change management and operational implementation of new programs, policies, or regulatory requirements. Licensure/Certifications
• Valid CA Registered Nurse (RN) license or Licensed Clinical Social Worker (LCSW) required. Driving
• N/A Duties & Responsibilities Essential Functions Leading People
• Develop, manage, and lead a team of self-accountable professionals by modeling real, personal accountability and instilling a culture of psychological safety and accountability.
• Support direct reports in holding themselves accountable to high performance standards and professional conduct in a clear, helpful, straightforward way.
• Conduct one-on-one conversations with direct report(s), focused on performance, development, and career growth.
• Ensure compliance with labor laws/regulations, support the implementation of organizational policies and procedures, and foster a positive and inclusive culture.
• Support the development, implementation, and monitoring of the department budget, to ensure efficient resource allocation and compliance with policies. Delivering Results
• Supervise and coordinate care management services; establish efficient workflows and address barriers to implementation.
• Create and revise workflows, job aids, and training materials to support staff and operations.
• Ensure staff consistently meet operational, clinical, and compliance standards. Leading Change
• Maintain and provide backup coverage to ensure achievement of all internal and external need, including creating, delegating, and managing special projects, audits, and reports.
• Provide caseload coverage as necessary in the absence of clinical and non-clinical staff.
• Drive team goals focused on health outcomes and high-quality member experience.
• Support Manager in developing and operating quality assurance programs for clinical and non clinical staff to strengthen best practices and service quality. Building Coalitions
• Lead hiring, onboarding, training, and evaluation of new staff.
• Partner with Manager to identify training needs and develop educational programs, training materials, competency tools, and orientation checklists that promote staff development and continuous quality improvement within ICM.
• Collaborate with Manager to ensure continuous quality improvement and monitor compliance with DHCS, CMS, NCQA and other governing organizations as required.
• Facilitate interdisciplinary team meetings (IDTs), case conferences, and team huddles. Secondary Functions
• Maintain a valid CA Registered Nurse (RN) license or Licensed Clinical Social Worker (LCSW).
• Promote culture of holistic member centric care with a focus on physical, behavioral health and social determinants of health.
• Adhere to work performance norms and attendance expectations.
• Perform other duties as assigned. The Health Plan of San Mateo (HPSM) is an equal opportunity employer and is committed to providing equal employment opportunities to all applicants and employees without regard to race, color, religion, creed, political affiliation, sex, gender, gender identity or expression, pregnancy, childbirth and related medical conditions, marital status, registered domestic partner status, sexual orientation, age, ancestry, national origin, citizenship status, veteran or military status, disability, medical condition, genetic information, or any other characteristic protected by applicable federal, state, or local law. This policy applies to all aspects of employment, including recruitment, hiring, selection, placement, promotion, transfer, demotion, compensation, benefits, training, discipline, and termination. HPSM is committed to providing reasonable accommodations to qualified individuals with disabilities and to applicants and employees with sincerely held religious beliefs or practices, in accordance with applicable law. If you require an accommodation during the application or interview process, or in order to perform the essential functions of a position, please contact the HPSM recruiter to request assistance.