SW Care Coordination Manager

M Health Fairview has an immediate opening for a Social Work Care Coordination Manager to join the FVP Care Management team. Join M Health Fairview, the largest healthcare system in the state! 

This is a full time, salaried role. This role is eligbie for the Management Incentive Program.

M Health Fairview offers a competitive benefits package including medical/dental, 401k/403b with employer match, tuition reimbursement, and PTO! For details, please visit our benefits page by clicking here!

Fairview Partners (FVP) provides high intensity care coordination and case management for seniors and other at-risk populations living in a variety of care settings in the 11-county metro area. The Social Work (SW) Care Coordination Manager assists the Director of Care Management in the day-to-day management of department care coordination staff and performs other administrative duties to support clinical operations, as assigned by the Director. The SW Care Coordination Manager assures that care is delivered according to department policy and models best practice in these case management functions: assessment, care planning, service coordination and referral, transition management, utilization management and quality assurance. Care coordination for the FVP population is delivered via partnerships with managed care organizations (MCO) and must adhere to regulations set forth by the MCOs, the Minnesota Department of Human Services (DHS), the Minnesota Department of Health (MDH) and the Centers for Medicare and Medicaid Services (CMS).

Job Expectations:

Acts as the Manager for a Fairview Partners geographical area and/or clinical team:

• Supervises a team of care coordinators, acting as immediate contact for staff questions and concerns
• Conducts annual performance reviews with staff
• Facilitates training opportunities for staff in coordination with department and system education resources
• Actively encourages employee development and meets regularly with staff members on a one-on-one basis
• Approves employee time cards and manages absenteeism according to system and department policy
• Enforces all other department and system personnel policies
• Acts as the hiring manager for approved positions in assigned area in consultation with the director

• Is present during interviewing process for potential employees outside assigned area, at the request of the director
• Serves as contact point for member complaints and grievances and has authority to reassign cases when necessary

• Follows Fairview’s policy for corrective or disciplinary action

• Rotates monthly case assignment with other managers and/or director
• Assures that care coordinators work at the top of their licensure
• Understands social work scope of practice as it applies to the FVP SW Care Coordinator role and provides professional guidance to staff as needed
• Represents Fairview Partners on system committees or workgroups, as requested by director
• Covers duties in absence of other managers or director’s absence

Provides Care Coordination/Case Management to the FVP population:

• Manages a panel of members in accordance with duties set forth in the FVP SW Care Coordinator job description
• Models best practice in all areas of care coordination/case management
• Gives clinical direction in accordance with CMS, DHS and health plan regulations
• Provides guidance to Case Management Specialist role as it pertains to member communication, service referral authorization and appropriate delegation of care management tasks

Maintains department clinical operations

• Maintains knowledge of current DHS policy concerning Long-Term Services and Supports, Medical Assistance benefit coverage and Elderly Waiver eligibility and benefits
• Maintains knowledge of Medicare benefits and policy as it applies to health plan contracted services
• Maintains knowledge of FVP clinical policies and network operations
• Promotes the Fairview system care continuum and maintains professional relationships with system care partners
• Coordinates with director to ensure updates from CMS, DHS, MDH and contracted health plans are distributed and understood by care coordination staff members
• Serves as point of contact for health plan communication; responds to health plan inquiries in a timely manner
• Attends all health plan care coordinator meetings
• Attends DHS and other training events at the request of the director
• Provides input to director for annual budgeting forecasts
• Leads staff meetings and huddles, as directed by management

Actively supports quality and process improvements to achieve superior clinical outcomes and financial performance for FVP:

• Participates in department quality and utilization meetings
• Attends interdisciplinary team conferences and provides clinical guidance to care coordination team regarding high-risk and complex behavioral or psychosocial cases
• Regularly reviews high-risk cases with team members to facilitate optimal clinical outcomes
• Provides input on and leads clinical performance improvement projects
• Supports efforts to maintain data integrity by enforcing department documentation and quality reporting standards
• Assists with annual health plan audit preparation, as needed, and attends health plan audit reviews

Organization Expectations, as applicable:

• Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served

• Partners with patient care giver in care/decision making.
• Communicates in a respective manner.
• Ensures a safe, secure environment.
• Individualizes plan of care to meet patient needs.
• Modifies clinical interventions based on population served.
• Provides patient education based on as assessment of learning needs of patient/care giver.

• Fulfills all organizational requirements
  • Completes all required learning relevant to the role
  • Complies with all relevant laws, regulation and policies
• Performs other duties as assigned.

Required

Education

Bachelor’s degree in Social Work.

Experience

Five to seven years care coordination/case management, public health, geriatric or medical social work, or managed care experience

Experience working with interdisciplinary clinical leadership teams on collaborative efforts

Supervisory/management experience

Strong knowledge of managed care programs, long-term services and supports, Medicare and Medicaid benefits and senior care industry

License/Certification/Registration

Current Minnesota Social Work license in good standing

Preferred

Education

Master’s Degree in Social Work

Experience

Seven to ten years of experience in care coordination/case management, public health, geriatric or medical social work, or managed care

License/Certification/Registration

Case Management Certification

Certified MnChoices Assessor

Additional Requirements (must be obtained or completed within a period of time):

Excellent computing skills including keyboarding, Microsoft Word, Outlook and Excel and Adobe Acrobat; demonstrated proficiency with electronic medical record systems; excellent written and verbal communication skills