CDPHP HARP Care Management Supervisor in Albany, New York

For more than 30 years, CDPHP has been providing outstanding health care coverage in the Capital Region of New York and beyond. Based in Albany, NY, the physician-guided not-for-profit offers plans in 24 counties. CDPHP cares deeply about the health and well-being of its members as well as its employees. The company values integrity, diversity, and innovation, and its corporate culture supports those values wholeheartedly. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.

The Care Management Supervisor is responsible for supervising the day-to-day operations of the Care Management (CM) Department. This responsibility includes daily supervision of the Care Management representatives to ensure that they respond promptly, effectively and courteously to inquiries from members, providers, prospective members and the general public, to ensure appropriate outreach is being made. Manage the staff schedule and caseloads. Provides expertise and staff support for problem-solving complex cases and issues. Takes the lead in staff evaluation and performance activities including hiring, monitoring, coaching, counseling, educating and developing action plans as needed. The CM Supervisor must have the experience to oversee a variety of workflows across a number of teams with varying roles. The CM Supervisor is responsible for the implementation of policies and procedures pertaining to department functions and for monitoring department operations consistent with those polices. The Supervisor also represents the organization to the general public and to member groups and participates in overall organizational management as warranted.

Under the guidance and supervision of the Director, Care Management, the CM Supervisor shares responsibility for the evaluation, planning, implementation, coordination and supervision of Care Management Department operations, functions and staff in alignment with corporate and departmental goals as well as applicable regulations and standards. The CM Supervisor is responsible for overseeing a team of clinicians who are charged with identifying member and family needs and coordinating care in a cost effective manner. The CM Supervisor is also responsible for assisting the Director with managing vendor relationships, physician relationships, contract obligations and delegate activities and oversight.

Represents CM and attends meetings for assigned committees, workgroups and teams. Supports the marketing department at sales renewal meetings as the clinical voice of CDPHP. Participates in required CM department data collection, documentation audits, reporting and analysis. Develops and supervises new staff orientation plans. Shares responsibility with other medical affairs supervisors for on-call supervision and provides coverage for the Director's time off as needed. Participates in CM Department quality initiatives. Responsible for the CDPHP population analysis and planning appropriate programming. Supports the mission, vision, values and standards of CDPHP.

QUALIFICATIONS:

  • Master’s degree required.

  • NY licensure: LSW, LCSW, licensed MFT, licensed RN (with BSN), and/or licensed PhD (psychologist)

  • Minimum number years of relevant case management experience:3

  • Experience in a lead capacity is preferred.

  • Familiarity with community resourcesand social service resources to assist patients with social needs preferred.

  • Experience in home care, medical office setting or managed health plan preferred.

  • Understanding of comprehensive care management services is required.

  • Ability to supervise and coach staff is required.

  • Ability to compile and analyze data is required.Experience with data retrieval and statistics is preferred.

  • Must possess strong oral and written communication skills, including experience with public speaking, required.

  • Flexibility to travel to a variety of sites across CDPHP service area is required.

  • Demonstrated ability to build relationships and connections across departments and divisions either as a facilitator or division representative is required.

  • Must be detail oriented and well organized.

  • Demonstrated knowledge with the regulatory requirements of DOH, CMS, DOI, NCQA.

  • Demonstrated ability to handle multiple projects and meet deadlines is required.

  • Excellent interpersonal, verbal, and written communication skills are required to engage practitioners and other external stakeholders and practice leadership in conversations related to program promotion and enhancement opportunities.

As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law.