Team Lead, Community Based Care Management - R13188-12

HAP Care Source is a joint venture between Health Alliance Plan (HAP) a Michigan-based health plan that provides health coverage to individuals and companies of all sizes, and Care Source a nationally recognized managed care organization with more than 2 million members. HAP Care Source extends and enhances the mission-based legacies of two trusted, midwestern nonprofit organizations – offering comprehensive health coverage, access to physicians and quality care with compassion.

The joint venture enables HAP Care Source to provide more Michiganders access to award-winning products, services and an expanded provider network and to expand services to Medicaid-eligible individuals in the Lower Peninsula.

The Team Lead, Community Based Care Management provides front line management and support to departmental leadership in the development and execution of the Care Model in alignment with corporate goals.

• Functions as a “hands‑on” supervisor, assisting in day‑to‑day operations and supervision of staff with adherence to departmental expectations.
• Responsible for recruiting, hiring, onboarding, training and ongoing support of the departmental team.
• Conducts meetings as needed (face to face or virtually) to train, lead, and support staff towards the effective administration of CM program.
• Prepares and utilizes reports to monitor and audit all systems, procedures and the quality of customer services provided. Assist with representing the unit at Departmental and Planning meetings as requested.
• Ensures staffing policies, procedures and SOPs are standardized and are current to meet business needs.
• Assists the Managers as needed in the review and development of new projects/processes as requested by the health plans.
• Oversee appropriate system documentation within defined protocols and guidelines.
• In support of the Strategic Plan, serve as the technical and content support to align programs/processes.
• Serve as interdepartmental liaison, collaborating with internal resources in monitoring service levels to meet requirements and analyze for trends.
• Participate in meetings with internal/external resources to provide information about services and benefits available to members and referral mechanisms.
• Assist in arranging and coordinating services with community partners to maximize utilization of appropriate community resources and support groups.
• Participant in development of budget and perform ongoing monitoring of status.
• Assist with implementation of interventions to maintain and/or improve the quality and efficiency of the operations/services provided.
• Perform any other job duties as requested.

• Completion of an accredited registered nursing (RN) degree program, Bachelor’s Degree in Social Work, or Master’s degree as relevant to licensure eligibility is required.
• A minimum of three (3) years of healthcare experience is required.
• A minimum of two (2) years of managed care and/or case management experience is preferred.
• Previous supervisory experience is preferred.

• Ability to display a customer service, member-focused orientation.
• Ability to travel as required by the needs of the business.
• Strong data analysis and trending skills.
• Strong team and staff development skills.
• Strong collaboration and conflict resolution skill sets.
• Ability to develop, prioritize and accomplish goals/time management.
• Strong decision making and problem solving skills.
• Exceptional communication skills (both written and verbal) with the ability to present information in a variety of different formats.
• Effective listening and critical thinking skills.
• Strong ability to teach best practice, engagement strategies for successful member participation (including motivational interviewing, best practice engagement techniques).
• Knowledge of state and federal healthcare regulations and environment.
• Ability to work in a fast-past environment.
• Ability to work independently and within a team environment.
• Advanced knowledge of Microsoft Word, Excel, PowerPoint and Visio.
• Ability to operate smart phone, iPad or other mobile communication devices.

• Active,…