Skip to Main Content
← Back to Jobs

Sr. Care Manager (LICSW, LGSW, LSWA, RN, LPN or LPC)

HSC Health Care System Washington, DC
  • Posted: over a month ago
  • Full-Time
  • Benefits: Vision, Medical, Life Insurance, 401k, Dental

JOB SUMMARY

The Senior Care Manager is responsible for the mentoring, training and supervision of care management staff and oversight of staff caseloads of members who have mild to complex medical and mental/behavioral health needs. This position has a broad knowledge base related to the needs of the Medicaid population and is an integral member of the Care Management Leadership team. The Senior Care Manager supports the operations of the Care Management Department through monitoring of staff’s adherence to quality and productivity standards; assisting with responding to member’s needs; and providing clinical supervision and leadership for compliance and performance improvement

JOB FUNCTIONS

Essential job duties:

1. Manages and assumes responsibility for day to day operations of an assigned team

2. Reviews cases regularly with staff; acts as a clinical consultant regarding care management issues; guides clinical staff with review of assessments and care plans, evaluates utilization reviews and/or documentation

3. Assists with the development of care coordination and care management activities that supports the health plans contract requirements

4. Assists Director in establishing, implementing, and ensuring care management policies, practices, and procedures are in place

5. In conjunction with VP and Director, coordinates, develops and implements action plan to respond to areas of need

6. Leads and offers expert guidance and direct supervision to the team in aspects of care management: assessment, planning and implementation, coordination

7. Assist the team with monitoring, and evaluation of options and services to meet the routine and complex health and behavioral health care needs of members

8. Monitors work performed by team members according to organization, department and community standards

9. Monitors productivity through the use of various reports to support appropriate outcomes and assign corrective action plans to staff as needed for immediate review and resolution

10. Conducts regular team meetings in accordance with contractual agreement and as needed

11. Completes all annual performance reviews by due date

12. Applies advanced problem-solving and analytical skills to evaluate and address complex situations involving members, providers, staff and community professionals

13. Submits routine and special reports as assigned or requested.

14. Participates in internal and external multidisciplinary rounds

15. Attends/conducts meetings internally or externally with other government agencies or community organizations involved with enrollees in the health plan as needed

16. Performs audits of member records on a weekly basis

17. Provides a level of oversight that assist the team members in maintaining caseload and contractual compliance metrics

QUALIFICATIONS

Required Experience:

1. Three years progressive supervisory experience

2. Three to five years of related experience in managed care and /or care management

3. Understanding of Medicaid benefits

4. Excellent verbal and written communication skills

5. Familiarity with computer systems and applications. Computer literate in Microsoft suite

6. Strong organizational skills

7. Ability to interpret and apply departmental requirements

8. Ability to make sound decisions and use good judgment

9. Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service

10. Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practice

License/Certifications

Licensed in DC as a Social Worker (LICSW), Registered Nurse (RN), or Licensed Professional Counselor (LPC). Certification in Case Management preferred.

Required Education

Bachelor’s degree required. Master’s degree preferred.

*Note: Master’s Degree required for identified groups of members per CASSIP contract

DC Residents are encouraged to apply!

HSC Health Care System

The HSC Health Care System provides and coordinates innovative, high quality, community-based care for individuals with complex needs and their families. HSC empowers all we serve to improve the quality of their lives. The HSC Health Care System (HSC) is a nonprofit health care organization committed to serving families and adults with special health care needs and eliminating barriers to health care services. The System combines the resources of a health plan (Health Services for Children with Special Needs, Inc.), pediatric specialty hospital (The HSC Pediatric Center), home health agencies (HSC Home Care, LLC and HSC Health and Rehabilitative Services), and parent foundation (The HSC Foundation) to offer a comprehensive approach to caring, serving and empowering people with disabilities. HSC employs over 700 staff members, with operating revenue of approximately $225 million annually. Strategic plans include further expansion of services into broader territories, including Virginia. As a first-of-its-kind health system in Washington, DC with more than a century of experience, The HSC Health Care System remains committed to changing the lives of the people we serve through expert medical care, care coordination and advocacy. Today, we are known for our expertise in treating children, teens and adults who have disabilities and complex medical conditions.

Address

1101 Vermont Avenue, Washington, DC 20005
Washington, DC
USA

What email should the hiring manager reach you at?

By clicking the button above, I agree to the ZipRecruiter Terms of Use and acknowledge I have read the Privacy Policy, and agree to receive email job alerts.

What email should we contact you at once we get salary info from the hiring manager?

By clicking the button above, I agree to the ZipRecruiter Terms of Use and acknowledge I have read the Privacy Policy, and agree to receive email job alerts.

Our qualification feature is only available to registered members - what email address would you like for us to keep on file?

By clicking the button above, I agree to the ZipRecruiter Terms of Use and acknowledge I have read the Privacy Policy, and agree to receive email job alerts.