Responsibilities: Essential Functions
1) Operational Efficiency
• Articulate performance expectations and team objectives while collecting and interpreting balanced measure to evaluate individual staff and team performance
• Assesses developmental needs and collaborates with the support team to identify and implement action plans that support the development of high performing teams
• Initiate root cause analysis and monitor action plans for identified opportunities
• Provide effective coaching and feedback to Nurse Associates that enable them to improve their performance
• Work closely with the Nurse Associates to identify areas for improvement and gaps in the process to create individualized and feasible action plans
• Monitor efficiency and initiate control measures to minimize variances in workload over time
• Executive monthly, quarterly, and annual performance review of Nurse Associates and consequent development processes effectively
• Ensures the team's understanding and use of information system capability and functionality
• Ensure implementation and monitoring of best practice approaches and innovations to better address the Case Manager and Utilization Management Nurse Consultant needs across the continuum of care
• Ensure compliance with internal policies and procedures, external regulations and information security standards
• Effectively forecast and manage the process volume, allocation, and staffing following the Statement of Work on a daily basis
• Maintain accurate reporting and cascading of information to internal and external stakeholders
• Update mandatory process trackers and files for compliance purposes
• Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking
• Oversee and facilitate implementation of updates management and training for new hires and/or team members
• Lead calibration sessions to ensure process knowledge alignment
• Monitor random transactions on an ongoing basis and take corrective steps where necessary or make incremental improvements
• May have responsibility for their own case load work
2) People Management
• Select staff using clearly defined requirements in terms of education, experience, technical and performance skills
• Formulate individualized plan with the CSRs/Nurse Associates to fully understand their career aspirations
• Develop a strong succession plan to encourage organic growth and facilitate “role ready” resources to ensures leadership continuity internally
• Create a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance, when needed
• Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance
• Initiate engagement activities such as Monthly Townhall, Team building, and Internal group sessions to promote camaraderie within the department
• Lead change efforts while managing transitions within a team
• Accountable for maintaining compliance with Human Resource policies and procedures and implements them at the employee level
3) Client Satisfaction
• Supervise the implementation of contact center management services
• Ensure business goals are met and compliance with policies and procedures is maintained
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality
• Handle client feedback and escalations
• Promotes communication, both internally and externally to enhance effectiveness of medical management services
• Produce monthly or weekly dashboard/business reviews in partnership with support teams
• Client interaction such as touch base, business reviews, and calls where Assistant Manager involvement is required
