Population Health Care Manager- Team Lead Medicaid

Population Health Care Manager—Team Lead Medicaid Work Arrangement: Requisition Number: 269596 Regular or Temporary: Regular Location: Durham, NC, 27710 Duke Connected Care , a community‑based, physician‑led network, includes a group of doctors, hospitals and other healthcare providers who work together to deliver high‑quality care to Medicare Fee‑for‑Service patients in Durham and its surrounding areas. Population Health Care Management Team Lead The Care Management Team Lead works in coordination with PHMO leadership in an assigned program to ensure that the work of care management staff is accomplished effectively. The role includes supervision of a team that oversees productivity, performance, and quality. In collaboration with managers, the Team Lead identifies plans and executes activities to promote effective quality care management, ensures compliance with policies and procedures, and may be assigned a small percentage of a caseload to engage customers within an identified population. The role models best‑in‑class care management through practical experience engaging the customers. Duties and Responsibilities Coordinate and facilitate timely implementation of appropriate interventions for identified customer populations following established policies and procedures, or recommend changes when gaps are identified. Monitor, support, and engage staff and management in systemic opportunities, strengths, and benchmarks that enhance negotiations with payers, improve care management, and address gaps in care using accessible data from multiple sources. Participate in hiring/firing processes of staff across care management. Engage with direct reports monthly via individual supervision and larger team meetings to provide timely updates, training, and coaching. Provide monthly productivity information. Shadow each direct report at least once per evaluation period unless higher frequency is required. Conduct one‑on‑one and group training for team members in workflow, documentation, and patient care needs. Manage time and attendance for staff in the API system. Complete routine audits in the data management system (MaestroCare/Virtual Health) and recorded calls for quality, clinical care, education, process accuracy, and overall experience of PHMO customers. Provide timely oversight and feedback. Participate in PHMO/DukeWELL meetings and role‑enhancing trainings that are appropriate at health system, state, regional, or national levels. Develop and maintain positive internal and external customer relationships. Maintain a small caseload with documentation, assessment, medication reconciliation, and care planning completed within required timeframes. Required Qualifications Education Requirements Bachelor’s degree in a clinical field such as Nursing, Counseling, Social Work, Therapy, Allied Health, or community health‑related fields. Experience 3 years of clinical experience. Care/Case management experience in settings such as Home Health, Community, General Medicine. Strategic Planning experience. Degree and Certification Current RN license in North Carolina (state or compact). Current NC Licensed Clinical Social Worker license (NC Board). Current NC Licensed Professional Counselor license. Current NC Licensed Addiction Specialist license. ACM or CCM certification within 3 years of hire or by December 31, 2020. Essential Physical Job Functions Certain jobs may include essential job functions that require specific physical and/or mental abilities. Requests for accommodation will be provided by each hiring department. Equal Opportunity Statement Duke is an Equal Opportunity Employer committed to providing employment opportunities without regard to age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy), sexual orientation or military status. Additional Information Read more about Duke’s commitment to affirmative action and nondiscrimination at hr.duke.edu/eeo. Nearest Major Market: Durham, Nearest Secondary Market: Raleigh #J-18808-Ljbffr Duke PF