Responsible for the management, direct supervision and coordination of clinical and/or nonclinical management staff, including care coordination and intensive care management staff, providing expertise in designated programs. Essential Job Functions
- Assists clinical coordination in the development and on-going management of designated staff.
- Performs care coordination review activities consistent with Magellan policies, procedures, and standards.
- Conducts recruitment, interviewing, and selection of properly qualified staff members and ensures appropriate orientation is provided.
- Regularly monitors the performance of care coordination staff. Monitors adherence to the efficiency goals for all staff including case volume, case closure rates, average handle time and other metrics.
- Supervises care coordination staff through approved audit processes including performing annual reviews and provides counseling and disciplinary action as necessary.
- Coordinates quality improvement activities under the direction of clinical management.
- Assists management in the development of strategic and operational goals and plans.
- Assists management in the identification and coordination of the necessary clinical and client service training needs.
- Supervises the collection of pertinent clinical information while maintaining a good rapport and relationship with providers.
- Bachelor degree in Nursing with current RN license or Master's degree and one of the following licenses: LCSW - Licensed Clinical Social Worker, LMSW - Licensed Master Social Worker, LPCC - Licensed Professional Clinical Counselor, LPC - Licensed Professional Counselor, PC - Professional Counselor, State and/or Compact State Licensure
- Minimum of five years of clinical experience with focus in managed care, including disease or case coordination.
- One year direct supervisory experience required.
- Demonstrated ability to communicate with members with complex medical needs and may have communication barriers.
- Thorough knowledge of physical, medical specialty and/or mental health community resources and providers.
- Thorough knowledge of healthcare services in physical health, behavioral health or other medical specialty area based on pod management.
- Considerable skill in interpreting clinical treatment information and making appropriate referral and triage decisions.
- Must meet Magellan's credentialing criteria for RN, Masters or Doctoral level provider.
- Bi/Multi Lingual preferred
Monday, June 5, 2017
Wednesday, July 5, 2017
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Full or Part Time: