Manager, Care Coordination

Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.

By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community.

Position Summary:

Manages a team of Care Anywhere (CAW) Clinical Coordinators and oversees activities that support the delivery of Care Anywhere services to high-risk members.  In this critical position, the Manager collaborates with the CAW clinical leadership team and the CAW Clinical Coordinator Supervisors to ensure services are scheduled and delivered timely to promote quality member health outcomes.   The Manager oversees coordination efforts that support optimal member outcomes and ensure consistent, cost effective care that complies with Alignment policy and all state and federal regulations and guidelines.

This position is responsible for the day-to-day operational performance of the CAW Care Coordination team. The Manager will ensure that direct reports are properly trained in job duties. Will work with each employee to create career goals and plans to attain them. The manager will evaluate each employee’s progress on a regular basis and determine whether more training is needed, goals are met, or plans need to be reevaluated.

Essential to the Manager role is contributing to the success of the company. The Manager’s actions should be poised toward business growth and comply with Alignment policies. The Manager will collaborate with the department Director and upper management team to promote successful growth within the department and throughout the company.

General Duties/Responsibilities (May include but are not limited to):

1.       Mentor, train, audit, coach and manage team of Clinical Coordinator Supervisors and team members to ensure compliance with Medical Management policies and procedures and ensure compliance with all regulatory requirements.

2.       Oversee the process, management and tracking of program outcomes to achieve performance goals.  

3.       Provides guidance to staff or directly manage complicated care coordination requests from members, providers, or staff.

4.       Assist with the development and oversight of CAW Care Coordination programs, projects, workflow, standard operating procedures, and reports.

5.       Create/Review workflows, job aid, standard operating procedures, and/or policies and recommend or change as appropriate to ensure timely, efficient, and effective outputs.

6.       Collaborate with other leaders in the department to improve processes and workflow.

7.       Assist with assessment activities and other process improvement strategies to enhance the effectiveness of the CAW Care Coordination department.

8.       Act as a resource to the members, providers, and leadership team.

9.       Communicate effectively, both verbally and in writing, including presentations as required.

10.   Establish and maintain effective interpersonal relationships with staff at all levels, providers, other departments, or programs.

11.   Build team engagement.

12.   Communicate with internal and external customers in a professional manner and follows through on commitments.

13.   Initiate and follow through on projects.

14.   Work well as part of a team to manage/lead multiple projects simultaneously.

15.   Think critically to solve problems effectively.

16.   Work closely as a liaison between management and the team to ensure that referrals/orders are assigned and touched in a timely manner.

17.   Function to gather data for analyzing and reporting purpose.

18.   Adheres to Confidentiality and HIPAA regulations.

19.   Other projects and duties as assigned.

SUPERVISORY RESPONSIBILITIES:

Oversees assigned staff. Responsibilities include recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees.

Minimum Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.       Minimum Experience:

a.       3 years of healthcare management experience; or any combination of education and experience, which would provide an equivalent background.

b.       1-3 years of Medicare Managed Care Health Plan experience

2.       Education/Licensure:

a.       Current, Active and Unrestricted Nursing license in the state in which you are applying (Preferred)

b.       Bachelor’s degree or higher in Health Care related field (Preferred)

3.       Other:

a.       Experience with Utilization Management processes (Preferred)

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.

Essential Physical Functions:

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.

1.       While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

2.       The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact [email protected].