Care Manager Supervisor PMAP/Restricted Recipient
Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
ABOUT UCAREAt UCare, we deliver high-quality health coverage and services to help members of all ages maintain and improve their health. It's a big job that takes innovative ideas, strategic partnerships, and a commitment to doing the right thing. Above all, it takes a compassionate team that is dedicated to making a real difference in the lives of our members and our communities. WORKING AT UCAREWorking at UCare is more than just a career; it's a mission. A mission that defines us as professionals, unites us as an organization, and shapes how we interact with our members and each other. Our values of integrity, community, quality, flexibility, and respect permeate every aspect of our organization - from who we are and how we act, to what we do and how we do it. We owe our continued success to our employees who proudly embody our mission and values in everything they do. CASE MANAGEMENT SUPERVISOR/PMAP AND RESTRICTED RECIPIENT (RR) Position DescriptionThis position is responsible to oversee daily operations of the team, refer issues to Care Management Manager as appropriate. Participate in the hiring and direct supervision of care management staff for assigned team(s). Collaborate with the Clinical Operations Manager to coordinate new employee orientation and evaluate staff development needs. Mentor, coach, and evaluate individual staff performance. Participate in the planning, implementation, and evaluation of care management activities to ensure quality services and compliance with contractual requirements. The team supervisor may be assigned a member caseload at the discretion of the Care Management Manager. Specific duties and responsibilities include: Oversee assigned team(s) in the performance of case management and restricted recipient (RR) program activities including identification of members meeting criteria, needing case management services, timely performance of case management assessments, implementing restrictions, development and implementation of care plans, and evaluation of member care outcomes.Assign members to care managers based on staff caseload size, member needs, and staff competency. Ensure members are assigned per protocol for assigned product(s), regulatory and/or accreditation requirements, timely member assessments, and equal distribution of case manager workload. Monitor delivery of case management/RR services. Ensure care management records meet contractual requirements. Review and evaluate care management staff documentation of assessments, care plans, and care coordination activities, audit member records, monitor staff productivity, identify system barriers and possible solutions.Provide training, supervision, and staff development to enhance the knowledge and skills of staff. Train staff on requirements for assigned product(s) and corresponding care management/RR processes. Report quality issues to manager, monitor problems on the team and ensure confidentiality of all member data, giving input and suggestions for improvement to the manager. Establish regularly scheduled one to one staff supervision at a minimum frequency of monthly to review and evaluate appropriateness of case management/RRservices and case management/RR activities. Establish regularly scheduled team meetings, assist with problem solving complex member care issues, conduct supervisory oversight of staff/member interactions at least quarterly. . Participate in implementing UCare strategy for care management in new markets and new products. Participate in administrative meetings as assigned by the Care Management Manager.Provide direct case management services to members based on current department caseload and the organization's business needs. Case Manager duties and responsibilities are described in the care manager position description. Ensure Transition of Care case management activities occur per the product care model and requirements.Perform operational duties related to specific products as assigned. Other projects and duties as assigned. EducationB.S.in nursing. RN diploma or Associate RN degree plus case management experience may be considered. Current Minnesota license as an RN.
Required ExperienceThree year's experience in care coordination/case management across the continuum of health care (hospital, clinic, nursing home, home care). One year of supervisory experience.
Preferred ExperienceExperience working with multi-cultural and underserved populations desired.
THE UCARE DIFFERENCEUCare is proud to be a recognized Star Tribune Top Workplace for the 7th consecutive year. As a part of our collaborative team, you'll experience the rewards that come with helping others and seeing the positive results of your hard work. We value and respect each individual's ideas and contributions, and give you the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, a myriad of volunteer activities, and a number of other rewards. If you're looking for a welcoming environment that celebrates what you have to offer, helps you build on your strengths, and gives you the opportunity to truly make a difference, we invite you to apply. As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.