The Team Leader of Case Management provides comprehensive management of the Case Management Team and facilitates the delivery of the highest standards for the Case Management Program, quality outcomes and operational efficiencies.
? Leads the Case Management Team by directing the activities of team members and draws upon CMSA, URAC accreditation standards, referral criteria and clinical expertise to manage all aspects of Case Management
? Assist in establishes goals and objectives for the CM Team and individual team member roles and responsibilities.
? Troubleshoots for problems and submits recommendations. May be required to interface with other areas, either internally or externally, to effectively resolve problems.
May provide direct supervision of staff, including performance reviews.
? Anticipates the resolution of issues through proactive and effective communication.
? Reviews Case Management data and discusses trends with the Clinical Manager.
? Possesses and maintain an in-depth knowledge of workflows, products, program components.
? Supports the development of solutions for issues and presents recommendations to the Clinical Manager and/or Clinical Director.
? Assists with the design, development, modification, of workflows for the Case Management Team.
? Works with members and providers to ensure that members receive education, coordinated services and advocacy that support optimal clinical outcomes.
? Monitors daily performance to ensure business goals are met and compliance with BHS policies and procedures. Assumes other duties/projects as assigned.
? AOC (MA)
? Other Duties as assigned
SCOPE: Case Managers must practice within the scope of their license (see Scope of Licensure statement). Non-certifications may not be issued on initial review, and always require consultation with a Physician or Psychologist Advisor.
Current, valid and unrestricted licensure for independent practice required with proof on date of hire. Re-verification will take place no less than every 3 years. A minimum of LICSW, LCSW, LMFT, RN, LMHC, with 5-7 years combined direct behavioral health, supervisory and/or managed care experience required.
The Team Leader for Case Management must have, or be working toward certification in Case Management. If the Team Lead has supervised the case management process for three years or more, s/he must hold a certification as a case manager.
Beacon Health Strategies, LLC - 23 months ago
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