Team Lead, Clinical Operations RN license Required – R9067 Position Available In Fulton, Georgia

Job Description:

Job SummaryRN License RequiredSouth GA preferredThe Team Lead,Clinical Operations

• Care Management provides front linemanagement and oversight for providing CareSource members with theright care at the right place at the right time and assisting themto achieve optimal clinical, financial, and quality of lifeoutcomes.

They are responsible for assisting in developing andexecuting the care model, aligning to corporate goals.

EssentialFunctions Support Care Management (CM) process for care coordination,provide support for UM cost drivers Utilize various reports to identify team concerns & supportstrategy for resolution Consult inside and outside of department and act as a SME fortraining enhancements as needed. Provide 1:1 support and or group support as needed to staff toimprove CM metrics and results. Provide leadership and direction to staff to ensure the goals,standards, and compliance with CareSource, federal and stateregulatory requirements are met Responsible for coaching and development of staff, and supportcontinuing education Perform ongoing monitoring of staff performance, scheduling,caseload allocation, productivity and quality to ensure equitableworkload distribution based on staff strengths, skills and businessneeds Contribute to continuous quality improvement Serve as interdepartmental liaison and network with otherdepartments to gather/share information about issues Assist in the development and review of department policies,procedures and processes Collaborate with other organizational departments onintegration of cross departmental processes to achieve optimalefficiencies Promote operational excellence through process improvement andchange management Collaborate with internal resources in monitoring servicelevels to meet requirements and analyze for trends Oversee departmental Clinical Quality initiatives andactivities Participate in meetings with internal/external resources toprovide information about services and benefits available tomembers and referral mechanisms Assist in arranging and coordinating services with communitypartners to maximize utilization of appropriate community resourcesand support groups Oversee appropriate system documentation within definedprotocols and guidelines Participant in development of budget and perform ongoingmonitoring of status Lead by example and “inspect” behavior to ensure that everyinteraction the employees have with our members will help themember to feel informed, empowered, and supported byCareSource Report team results that demonstrate engagement rates, lowGrievances & Appeals, continuous Improvement and other metrics thatshow how their behavior is impacting a positive consumerexperience Conducts meetings as needed (face to face or virtually) totrain, lead, and support staff towards the effective administrationof CM program. Provide support as needed for regulatory activities. Promote CM industry standards and best practices incommunication with staff. Perform any other job duties as requestedEducation AndExperience Associate’s degree in healthcare or related field or equivalentyears of relevant work experience is required Bachelor’s degree is preferred A minimum of three (3) years of healthcare experience isrequired A minimum of two (2) years of managed care and/or casemanagement experience is preferred Previous supervisory experience is preferredCompetencies,Knowledge And Skills Proficient in Microsoft Office Suite, to include Word, Exceland PowerPoint Ability to operate smart phone, iPad or other mobilecommunication devices Excellent written and verbal communication skills Ability to create a positive work environment that promotesemployee engagement and goal achievement Ability to develop, prioritize and accomplish goals Effective listening and critical thinking skills Ability to work independently and within a teamenvironment Knowledge of state and federal healthcare regulations andenvironment Awareness of community and state support resources forpopulated served Proven track record of leading teams focused on the consumer /member experience that demonstrated empathy and compassion andtracked results Proven track record in driving continuous improvement effortsto improve member experience and tracked results Contribute to continuous quality with knowledge in QA ananalyticsLicensure And Certification Active, unrestricted State Licensed Practical Nurse (LPN),Registered Nurse (RN) license is required CCM is preferred To help protect our employees, members, and the communities weserve from acquiring communicable diseases, Influenza vaccinationis a requirement of this position. CareSource requires annual proofof Influenza vaccination for designated positions during Influenzaseason (October 1

• March 31) as a condition of continuedemployment.

Employees hired during Influenza season will havethirty (30) days from their hire date to complete the requiredvaccination and have record of immunization verified. CareSource adheres to all federal, state, and localregulations. CareSource provides reasonable accommodations toqualified individuals with disabilities or medical conditions,sincerely held religious beliefs, or as required by state law toenable the employee to perform the essential functions of theposition. Request for accommodations will be completed through aninteractive review process.

Working Conditions General office environment; may be required to sit or stand forextended periods of time Ability to travel as required by the needs of thebusinessCompensation Range$70,800.00

• $113,200.

00 CareSource takesinto consideration a combination of a candidate’s education,training, and experience as well as the position’s scope andcomplexity, the discretion and latitude required for the role, andother external and internal data when establishing a salary level.

In addition to base compensation, you may qualify for a bonus tiedto company and individual performance. We are highly invested inevery employee’s total well-being and offer a substantial andcomprehensive total rewards package.

CompensationTypeSalaryCompetencies Create an Inclusive Environment

• Cultivate Partnerships
• Develop Self and Others
• Drive Execution
• Influence Others
• Pursue Personal Excellence
• Understand the BusinessThis jobdescription is not all inclusive.

CareSource reserves the right toamend this job description at any time. CareSource is an EqualOpportunity Employer. We are dedicated to fostering an inclusiveenvironment that welcomes and supports individuals of allbackgrounds.