Job Description:
Provide comprehensive healthcare management to facilitate delivery of appropriate quality healthcare promote cost effective outcomes and improve program/operational efficiency involving clinical issues.
Position Overview
The primary role is to meet the service level agreement of the process by coaching the CSRs/Nurse Associates to meet their monthly goals. They develop and mentor their direct reports to expand their capabilities and reach their full potential. They work with a team of Assistant Managers and Support staff to maintain effective team working relationships hence ensuring high level of engagement and morale in their respective teams.
- The Assistant Manager is responsible for management of CSRs/medical services staff including the organization and development of high performing teams
- Works closely with managers ensuring consistency in care management interventions
- Facilitates effective interfaces among team members as well as across teams providers and departments
- Responsible for the day-to-day implementation of medical management services policies and procedures
- Accountable for meeting the financial operational and quality objectives of the unit
Essential Overview:
- 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 annualperformance review ofNurse Associates and consequent development processes effectively
- Ensures the teams 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
- 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 andInternal 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
- 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
- Reports to:
- Lead Assistant Manager/Operations Manager/Senior Operations Manager
- Supervises:
- Executive and Senior Executives and Subject Matter Experts
- Collaborations to:
- Other Assistant Managers
- Lead Assistant Managers
- QCA/QC AM
- Process Trainer
- MIS and WFM
- Enabling Function Staff (HR Personnel IBMS Staff IT Resource Clinic Staff)
- HCA Staff
- Stateside Counterparts
- Process owners
- Case Managers
- Supervisors/Team Leads
- Product Customer
- Providers from Doctors Office and Facilities
- Representatives from Plan Sponsors
- Members
Process Specific Skills
- 1. Domain expertise is a must
- 2. Demonstration of profound familiarity and technical skill relevant to the process
- 3. Understanding and demonstrating the knowledge of end-to-end processes and appreciation of critical parameters
- 4. Able to identify with and comprehend data and new information
- 5. Planning and Organizing skills - ability to prioritize the tasks and deliver assigned task per deadlines
- 6. Execution of providing customer service
- 7. Must have experience in handling teams
- 8. Must have experience in handling escalations
- 9. Familiarity with basic medical terminology and concepts used in care management
- 10. Knowledge with US healthcare set up is a plus
- 11. Ability to effectively participate in a multi-disciplinary team including internal and external participants
- 12. Keen on details essential for clinical documentation
- 13. Ability to multitask prioritize and effectively adapt to a fast paced changing environment
Soft Skills
- Coaching and mentoring skills
- Above average presentation skills
- Listening and time management skills
- Self-disciplined and results oriented
- Strong motivation and willingness to step up and accept the challenge of the role
- Flexibility and urgency to handle pressure
- Ability to discharge the responsibilities in a conflicting environment
- Problem identification and analytical ability
- Ability to multi task
- Interpersonal Skills
- Customer Service Focus
- Team Work and Adaptability
- Ability to work with cross-cultural staff
- Management principles human resources procedures customer service and computer skills
- Verbal and written communication skills of at least B1 CEF level
Required Experience:
Manager