naviHealth, Inc. Clinical Team Manager in New York City, New York
The Clinical Team Manager (CTM) is responsible for the day to day management and leadership an assigned field clinical operations team. The CTM participates in the hiring and onboarding of new colleagues and the continued clinical development of all colleagues. The position ensures that staff understand and adhere to established clinical protocols and processes. The position may work with internal and external partners, local leadership, and centralized operational teams to deliver efficient compliant processes that result in a positive member and provider experience.
Manage day to day activities of Care Coordinators as assigned. May include assigned caseload to manage or functioning as a Care Coordinator when work caseloads require.
Monitor colleague caseloads daily and recommend adjustments in assignments for equity.
Approve PTO requests ensuring adequate staffing is available to meet the needs of the department. May provide coverage of PTO of assigned team members.
Review and update CMT Managers Tab (facility assignments) daily.
Facilitate weekly rounds, including but not limited to SNF/IRF/LTAC and/or readmission.
Cultivate a strong internal culture designed around collaboration, feedback, motivation, and accountability.
Participate in the hiring process with General Managers and Senior Clinical Managers (SCM).
Participate/conduct colleague performance reviews.
Ensure the successful onboarding of all new colleagues by completing the 90-day competency review. Report any barriers to SCM and arrange for ongoing support as identified.
Ensure all required home office inspections are completed annually.
May function as a preceptor and/or mentor or collaborate closely with a colleague until they are can function independently.
Review key metrics with Market Leadership including daily and weekly reporting reviews.
Participate in MMR reviews and provides support/coaching/training to improve performance for colleagues scoring below the acceptable threshold.
Monitor and measure the execution of the naviHealth clinical model with a focus on improving patient outcomes. May recommend process and policy changes to SCM based on results from these measures.
Conduct weekly team meetings.
Facilitate weekly 1:1 meetings with assigned colleagues performing both clinical record reviews and offering guidance/support on challenging cases.
Observe colleague performance via observations at set intervals, as determined by the market, but no less than quarterly.
Collaborate with internal business partners/Shared Services area to achieve and maintain all contractual service language agreements.
Ensure compliance with all federal and state regulations, accreditation organizations, and client requests.
Perform other duties and responsibilities as required, assigned, or requested.
Active, unrestricted registered clinical license required – Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Therapist
At least 5 years of clinical management experience required
Experience managing multi-disciplinary care teams, including nurses, therapists, social workers, or case managers
Experience working with geriatric population preferred
Exceptional verbal and written interpersonal and communication skills
Independent problem identification/resolution and decision-making skills
Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously
Knowledge of InterQual and Milliman a plus
Knowledge of NCQA and URAC standards a plus
Certification in case management (Commission for Case Management Certification (CCMC); Association of Rehabilitation Nurses (ARN) if appropriate) preferred
Work Conditions and Physical Requirements
Ability to establish a home office workspace
Ability to communicate with clients and team members including use of cellular phone or comparable communication device
Ability to sit for an extended time period (1 - 2 hours)
Ability to mobilize to and within sites within an assigned local or regional market/area up to 75% of the time
Some overnight travel may be required – up to 15% of the time
naviHealth is improving the healthcare experience for seniors to live more fulfilling lives. For nearly a decade, naviHealth has been a trusted partner for the nation’s top health plans, health systems, and at-risk physician groups navigating the shift from volume to value. Powered by a predictive technology and decision support platform that provides clinicians and care teams with evidence-based protocols, naviHealth’s high-touch, proven care model fully supports patients from pre-acute through to the home. With naviHealth, patients can enjoy more days at home, and healthcare providers and health plans can significantly reduce costs specific to unnecessary care and readmissions. For more information about naviHealth, visit www.navihealth.com.
Improving the healthcare experience for seniors to live a more fulfilling life
Rooted in respect
Guided by purpose
Devoted to service
Energized by impact
The above statements are intended to describe the general nature and level of work performed by colleagues assigned to this job. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications. naviHealth reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.
naviHealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other protected status under applicable laws and will not be discriminated against on the basis of disability.
Requisition ID: 2020-4155
Location Type: Field / Office / Virtual: Field (in Market)