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At PHP we believe in providing high quality, efficient care for nearly a half-million Coloradoans. One of the ways we do that is by taking care of our employee’s first. Benefits include competitive compensation, a generous health plan, vision, dental, life insurance, and 401(K) matching. In addition to the essential benefits, we also offer some fun ones like exercise incentives, happy hours, profit sharing, and philanthropy projects. These are just some of the reasons why we have been ranked a Top Workplace in the Denver Post for 7 years!
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Supervisor, Care Coordination (Medicaid)
- Job Title
- Supervisor, Care Coordination (Medicaid)
- Denver, CO 80202
- Other Location
Position Summary: The Supervisor, Care Coordination will support Colorado Community Health Alliance (CCHA) initiatives and the Primary Care Medical Provider’s effort in providing a medical home for Medicaid members. The Health Partner Supervisor will facilitate and promote teamwork among the CCHA Health Partners to help Medicaid members maximize use of existing health services by supporting daily operations of care management programs and processes.
Communicates well both verbally and in writing, creates accurate and punctual reports, delivers presentations, shares information and ideas with others, has good listening skills.
- Promotes team communication and acts as the subject matter expert for HPs to assure best practices in care coordination programs, provides feedback on team recommendations to manager
- Responsible for program reports to include analysis and recommendations of program changes.
- Attends meetings representing Care Management Department
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.
- Distributes and manages case workloads, P&Ps, and workflow for Health Partners
- Provides feedback on current programs to include suggestions for process change and assists with development and implementation of new initiatives.
Anticipates and resolves conflicts, turns team diversity into an advantage, uses unique team talents, defines processes and goals, works for consensus.
- Develops and leads HP team and fosters team unity to include coordinating PTO coverage and communicating coverage assignments to CCHA Health Partner team.
- Responsible for hiring, monthly 1:1s and evaluation of Health Partners, to include coordination of new staff orientation and on-going education of program changes
Provides feedback and coaching, rewards hard work and risk taking, takes mentoring role, challenges and develops employees, accepts mistakes, provides visibility/opportunity.
- Performs daily coaching/mentoring and acts as the single point of contact for health partners. Provides feedback on team performance to supervisor and/or manager and assists in development of action plans
- Performs auditing of team care coordination efforts to include providing coaching on health coaching model, motivational interviewing, standard operating procedures, performance and goals.
Builds customer confidence, is committed to increasing customer satisfaction, sets achievable customer expectations, assumes responsibility for solving customer problems, ensures commitments to customers are met, solicits opinions and ideas from customers, responds to customers.
- Develops strong telephonic and in person relationships with members, providers and community agencies to include handling escalated Medicaid member calls
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.
- Designs and reviews productivity and utilization reports. Provides assessment of utilization and program data to make suggestions to the Manager for strategic planning, service design, implementation, and evaluation. Monitors caseloads, referral volume, case management, and data entry.
- Demonstrates working knowledge of laws, standards and policies applicable to Care Management. Assists Manager in monitoring compliance and adherence to Care Management Standard Operating Procedures.
- Maintain confidentiality and ensure compliance with HIPAA regulations.
- Other duties as assigned.
- Graduate of accredited school of nursing with RN or Masters level health care related degree (MSW preferred).
- One to three years’ experience in a supervisory capacity.
- Previous experience with Medicaid preferred.
- Bilingual (English/Spanish) preferred.
- Knowledge of case management, community resources/agencies, Medicaid and other social service related programs and processes, program and workflow development, process improvement and implementation.
- Excellent verbal and written communication skills and the ability to convey information clearly to both internal staff and external members/partners to include staff education and coordination and facilitation of meetings/events.
- Skilled in conflict management to assure problem prevention and resolution.
- Skilled in time management and ability to complete tasks on time and ability to multi-task.
- Intermediate level of competence with various computer software applications including MS Outlook, Word, Excel, and Power Point.
- A valid unrestricted Colorado drivers’ license.
- Reliable and insured vehicle.
- Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and procedures.
- Mobile Device for work purposes as defined by the company policies and procedures.
Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is frequently required to stand; walk; reach with hands and arms and stoop, kneel, crouch, or crawl. The employee is occasionally required to climb or balance. The employee must regularly lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.
Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.