Manager, Care Integration Team

Description

Our Organization
Humana’s Primary Care Organization is one of the largest and fastest growing value-based care, senior-focused primary care providers in the country, operating over 270 centers serving over 250,000 patients. As a payor-agnostic, wholly owned subsidiary of Humana, our centers put the unique needs of seniors at the center of everything we do. Our Clinics offer a team-based care model supporting patients’ physical, emotional, and social wellbeing.

At CenterWell Senior Primary Care and Conviva Care Centers, we want to help those in the communities we serve, including our associates, lead their best lives. We support our associates in becoming happier, healthier, and more productive in their professional and personal lives. We promote lifelong well-being by giving our associates fresh perspective, new insights, and exciting opportunities to grow their careers. Our culture is focused on teamwork and providing a positive and welcoming environment for all.

Responsibilities

The Role

The Care Integration Team Manager is responsible for managing a team of nurses, community health workers, and behavioral health resources who engage high risk/high needs patients using a team-based approach to ensure patients receive the individualized care and services they need to reach optimal health. The Manager is also responsible for building strong partnerships with clinical-operational market leaders on Care Integration Team foundational program and strategic opportunities for managing populations and coordinating care to reduce acute and post-acute care utilization. The Manager role is hybrid with travel requirements to preferred healthcare facilities in the community, alongside clinical market leader, to develop clinical partnerships for timely access to patient information, clinical collaboration on patient care, and patient centered resources.

As a guideline, this role involves spending 50% of the time on operational excellence and program delivery, 25% on relationships, and 25% on community partnerships.

Major Duties and Responsibilities

• Oversees day-to-day operations, quality chart audit reviews, recruiting/hiring, team management, and overall performance for Care Integration Team associates in the market.
• Ensures clinical program integrity at the market level and addresses performance and program improvement opportunities, escalating to Divisional Director as appropriate.
• Collaborates with market leader/key stakeholders to design market specific strategies, data analytics, and create action plans that will reduce acute and post-acute care utilization. 
• Solicits/shares feedback with market leaders on team-based focus with attention given to success and opportunities to improve one care team culture and collaboration on high-risk patient management, at the market level. Effectively prioritizes patients with the market leaders who benefit the most from care management programs.
• Initiates and maintains relationships with community partners, including key community organizations, Centerwell organizations (home health and pharmacy), and health care systems for strong clinical collaboration that will improve patient experience and overall population health outcomes.
• Accountability to key population health metrics, including quality, utilization and financial measures.

Required Qualifications

• A current unrestricted state RN license or social work degree / license
• 5 years or more prior nursing, case management, disease management and/or social work experience
• At least 2 years of team management experience
• Experience working in primary care value based care organizations
• Proficiency in analyzing and interpreting data trends
• Progressive business consulting and operational leadership experience
• Comprehensive knowledge in Microsoft office products
• Must be passionate about contributing to an organization focused on continuously improving customer experience
• Must provide a high speed DSL or cable modem for home office
• Must have a separate room with a locked door that can be used as home office to ensure you have absolute privacy
• Driving required to community organizations, health systems, and CW centers
• Characteristics of the qualified candidate: 
  • Capable of setting SMART goals, aligned with organization, and holding staff accountable for achieving goals.
  • Excellent communication skills, including follow-through communication and the ability to interpret and translate data to tell a story via executive level presentations.
  • Relationship management and negotiation skills to ensure key organizational and community partners feel engaged, heard, and respected. 
  • Pro-active, positive attitude, and comfortable being a change agent
  • Ability to lead and facilitate meetings with MDs, Operations Leaders and across a matrixed organization.
  • A passionate advocate for improving clinician and patient experience through population health management.

Preferred Qualifications

• Bilingual in English/Spanish with the ability to speak, read and write in both languages without limitations and assistance

               

Benefits

Health benefits effective day 1

Paid time off, holidays, volunteer time and jury duty pay

Recognition pay

401(k) retirement savings plan with employer match

Tuition assistance

Scholarships for eligible dependents

Scheduled Weekly Hours

40