Work At PHP - Physician Health Partners

Current Job Postings

Manager, Care Coordination (Medicaid)

Job Title
Manager, Care Coordination (Medicaid)
Job ID
27169336
Location
Denver,  CO 80202
Other Location
Description

Position Summary:  Responsible for cross-program operations of CCHA Care Coordination programs. Collaborates across departments, including behavioral health, to create integrated priorities, and implement strategies and initiatives to achieve CCHA goals and outcomes. Supports alignment of CCHA’s care coordination programs though focusing on operational efficiencies and program evaluation. Provides clinical management support to the CCHA Care Coordination management and supervisor team, including integration of physical & behavioral health.  Works with the Care Coordination Director and leadership team to coordinate content and completion of CCHA Care Coordination deliverables. Represents CCHA’s Care Coordination programs in community, stakeholder and HCPF meetings.

 

COMPETENCIES/Role-Specific Functions: 

ORGANIZATIONAL SAVVY

Operates within the organization's formal and informal structures, builds allies and relationships across departments, uses allies to build consensus and create results, is appropriately diplomatic, understands others' roles and perspectives, can sell projects and ideas across the organization.

  • Coordinates with Director and managers to provide leadership and direction on cross-program design, implementation and evaluation.
  • Works with the Care Coordination Director to initiate, plan and represent CCHA in community, provider and HCPF activities.
  • Coordinates across CCHA departments to assist with operationalizing CCHA’s care coordination programs within the health neighborhood, provider offices, hospitals, and the community.
  • Works with Director to support analysis and program data to include making suggestions for and implementing clinical process changes, improvements, program design and implementation of new initiatives.
  • Creates and maintains successful relationships within the broader RAE structure, including other CCHA departments, BH leadership, community stakeholders and providers.

 

DECISION MAKING/JUDGEMENT

Recognizes problems and responds, systematically gathers information, sorts through complex issues, seeks input from others, addresses root cause of issues, makes timely decisions, can make difficult decisions, uses consensus when possible, communicates decisions to others.

  • Assists direct reports in decision making to monitor effectiveness of care coordination initiatives and programs.
  • Collaborates in decision making and problem solving when appropriate with directors and managers.

 

PLANNING  

Develops realistic plans, sets goals, aligns plans with company goals, plans for and manages resources, creates contingency plans, coordinates/cooperates with others.

  • Supports cross-program processes for identification and assignment of targeted populations to maximize effectiveness of care coordination programs; and data analysis to ensure adherence and fidelity to the programs and workload leveling.
  • Works with leadership to implement & evolve programs throughout the evolution of the RAE, HCPF and market changes.
  • Works with the Care Coordination Director and leadership team to coordinate content and completion of CCHA Care Coordination deliverables.

 

PEOPLE MANAGEMENT

Defines roles and responsibilities, applies clear/consistent performance standards and provides feedback and coaching. Handles performance problems decisively and objectively, provides guidance and assistance to improve performance, rewards hard work and risk taking, motivates, challenges and develops employees, delegates effectively.

  • Performs coaching, mentoring, oversight and development for CCHA’s Care Coordination management team.
  • Works with the Director and other managers to develop policies and procedures, productivity reports and compliance monitoring.

 

CUSTOMER FOCUS

Plans for and uses resources efficiently, always looks for ways to reduce costs, creates accurate and realistic budgets, tracks and adjusts budgets, contributes to budget planning.

  • Develops and maintains a good working relationship with CCHA key partnerships
  • Ensures reporting commitments to key partners, including HCPF and providers, are met

 

JOB KNOWLEDGE

Understands duties and responsibilities, has necessary job knowledge, has necessary technical skills, understands company mission/values, keeps job knowledge current, is in command of critical issues.

  • Provides clinical oversight of all outpatient Care Coordination functions including, but not limited to, CCHA Care Coordination cross-program design and implementation, care transitions and care coordination processes.
  • Represents CCHA Care Coordination in internal meetings and workgroups and community based organizations.

 

BUDGETING

Plans for and uses resources efficiently, always looks for ways to reduce costs, creates accurate and realistic budgets, tracks and adjusts budgets, contributes to budget planning.

  • Other duties as assigned.

 

 

Qualifications (Education/Experience/Knowledge/Skills): 

  • Graduate of accredited school of nursing with RN, Licensed Clinical Social Worker, or Masters level health care related degree. Minimum 5 years clinical experience as RN or Licensed Clinical Social Worker, or Masters level health care related degree.
  • Minimum 5 years experience in management of healthcare related staff
  • Minimum 3 years experience in program design, implementation, and evaluation
  • Experience with Health First Colorado, Colorado’s Medicaid program preferred
  • Knowledge of NCQA, QA, Medicare/Medicaid guidelines, program and workflow development, process improvement and implementation procedures, care coordination, especially care transitions models and health coaching models
  • Skilled in exercising a high degree of initiative to achieve organizational objectives
  • Skilled in teaching others and acting as a subject matter expert, motivational interviewing, judgment and decision-making, customer service by being able to relate well to all kinds of people inside and outside the organization, builds appropriate rapport, uses diplomacy and tact, can diffuse even high-tension situations comfortably
  • Able to perform intermediate level of competence with various computer software applications including MS Outlook, Word, Excel, Access, and Power Point
  • Able to think critically and problem solve varying degrees of complexity
  • Able to earn respect of practices and peers and community organizations
  • A valid unrestricted Colorado drivers’ license. 
  • Reliable and insured vehicle.   

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