Team Manager - Keystone First CHC

Company Description

Patient Care Coordination, Inc. is a Service Coordination Entity serving all 67 counties in Pennsylvania and a contracted partner with various healthcare organizations. PCC's mission is to Advocate, Assess, Monitor, and Connect participants to community services that maintain their health, safety, and independence. PCC focuses on individualized participant-centered services with an interdisciplinary team approach.

Job Type: Full-time

Pay: $48,000.00 - $60,000.00 per year

Key Responsibilities

• Responsible for the operational functions of the service coordinator team assigned to a designated LTSS CHC health plan MCO.
• Support and supervise staff providing day-to-day supervision, including direct administrative and clinical supervision (if applicable based on licensure)
• Establishes and maintains production and quality standards by developing and ensuring compliance with all customer service and process standards through reviews, monitoring audits, reports, and practices. Provides direct and timely feedback to all staff on the results.
• Ensure all service coordination responsibilities are completed in compliance with MCO-specific contract requirements including participant assessments and person-centered service plans.
• Stays up to date with all CHC waiver changes and MCO changes and training then ensures all Service Coordinators on their team are trained on changes.
• Acts as the main point of contact and mentor for training; ensures required training and educational needs of staff are met during initial orientation and at least annually per CHC agreement requirements and OLTL standards; Follows training guidelines and offers in-service support on an ongoing basis.
• Collaborate closely and develop strong working relationships with assigned MCO internal service coordination team; Maintain a high level of customer service and responsiveness to the health plan; instill a positive image of PCC at the designated health plan and with partner organizations and throughout the community.
• Ensures accurate and timely documentation of all services provided and other related paperwork per PCC contract with the MCO and CHC Agreement requirements.
• Coordinate intake of participants accepted by PCC and ensure documentation and permissions are reviewed and signatures obtained for the delivery of services, choice of providers and participant's rights and responsibilities.
• Monitor productivity and quality of the team to ensure PCC standards are maintained; Maintain appropriate tracking of department statistics based on organizational and regulatory standards to ensure compliance with OLTL and NCQA requirements as well as MCO quality standards.
• Review the team’s performance against established company goals and OLTL guidelines: Identify problems and initiate a corrective action plan as needed
• Schedules routine coaching interactions with the service coordinators on the team to drive performance expectations; Completes performance evaluations and adheres to established performance evaluation timeframes
• May be responsible for a caseload of individual participants; Maintains and exceeds daily, weekly, and monthly billing requirements per the billable unit standards currently established for team managers as well as adhering to the highest quality standards for service coordination delivery to assigned participants.
• Assists and audits service coordination visits and monitoring calls and maintains compliance and integrity of participant care while ensuring high levels of customer satisfaction.
• Coordinates and conducts department meetings regularly; attends all other regularly scheduled staff meetings
• Provide the best customer care possible, including reliability in working scheduled hours; Take the lead in handling all crisis situations and provide solutions and direction to team members to help problem solve and clear barriers to effectively meeting the needs of our participants and MCO partners in person-centered care planning.
• Create an organizational culture that respects and celebrates the diversity of our participants; maintain a participant-focused level of practice that adheres to the company’s mission and values, and per OLTL regulations.
• Perform other duties as assigned.

Qualifications

• Bachelor's degree required (social services or human services field preferred); Master’s degree preferred.
• 3 years’ experience in human services/case management is preferred
• 3 years or more managing others within the capacity of Supervisor or Manager within similar roles in Service Coordination preferred, but not required
• Strong knowledge of MCO software is desirable
• Knowledgeable on CHC Waiver
• Solid understanding of MCO model and expectations
• Ability to learn new systems and then effectively train others
• Strong critical thinking and problem-solving skills
• Ability to act as a liaison between PCC and MCO
• Proficient in MS Office applications with an emphasis on Excel
• Ability to organize multiple tasks promptly
• Travel throughout Philadelphia and/or surrounding counties is required up to 30% per week, as needed
• Ability to guide and mentor staff and encourage high levels of quality and productivity
• Motivate staff and colleagues in acquiring goals and maintaining high levels of quality output

Benefits

• 401(k)
• 401(k) matching
• Dental Insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance
• Rewards Program