12 days old

Tm Ldr Health Services - Care Team

Des Moines, IA 50309

Job Summary<\/h2>

Help us lead change and transform the member experience<\/strong><\/p>

The health care industry is changing, and Wellmark is working to help change it for the better. We recognize that our members deserve health care with a focus on quality. We also recognize that health care is complex. Were embarking on a journey to help our members use and navigate the health care system in order to help them make clear, informed decisions, and were also ensuring that we take a team-centric approach when working with and in support of our members. The work that our diverse business and care teams are doing in collaboration with our health care partners will create these changes, all while working to minimize health care costs.<\/p>


Use your strengths as Team Leader Health Services \u2013 Care Team <\/strong><\/p>

In this role, you lead a member-centric clinical team focused on experience, engagement and care coordination to help members navigate and use the complex health care system. You provide planning, leadership and situational guidance to staff, ensuring member/customer inquiries and issues are resolved timely and accurately for an optimal member experience. You also serve as a clinical resource for complex or escalated issues. Because this role is a leader of others, you directly impact the success, growth, and development of team members by setting clear expectations, defining accountabilities, coaching to team members strengths, facilitating change, and providing an overall positive and team-centric work environment. Being a role model in behaviors that demonstrate Wellmarks core competencies and strengths-focus is a must. <\/p>


Ideal candidates are passionate about leading teams and are skilled at inspiring and coaching others to creatively solve problems, learn, grow, and continuously improve. Eager to apply their clinical expertise in new ways, theyre adaptable, resourceful, willing to learn Wellmarks business, and assist with a wide mix of tasks and projects. Theyre also known for their thoughtful, yet agile approach and their desire to create high quality, positive member experiences.<\/p>


Minimum Qualifications:<\/u><\/strong><\/p>

  • Active and unrestricted Registered Nurse (RN) license in Iowa; individual must be licensed in the state in which they reside.<\/li>
  • Certified Case Management (CCM); must attain CCM within 24 months after hire and maintain throughout employment.<\/li>
  • Completion of an accredited RN program.<\/li>
  • 4+ years of diverse clinical experience (e.g., acute care, outpatient, home health, etc.)<\/em> in a health care, health insurance, or similar work environment that reflects:
    • A minimum of 4 years of direct clinical care to the consumer.<\/li>
    • Management of complex cases or care plans with increasing levels of accountability; demonstrates a proactive approach and ability to think ahead in a patients/members care plan. Care navigation/care coordination experience strongly preferred. <\/li>
    • Track record of success leading initiatives, projects or programs.<\/li> <\/ul><\/li>
    • Proven formal or informal leadership experience. Ability to lead, coach, engage, and develop team members in a dynamic/changing work environment where member experience, production, quality and outcome goals are monitored, measured and reported on. <\/li>
    • Demonstrated commitment to service excellence and advocacy for member care.<\/li>
    • Ability to operate with agility and flexibility; effectively moves from strategy to tactics to operations.<\/li>
    • Strong verbal and written communication skills, including the ability to coach, influence action, and facilitate crucial conversations. Timely submissions of escalation and briefing documents.<\/li>
    • Proactive, resourceful self-starter. Strong understanding of resources, processes and guidelines. Independently makes decisions and develops recommendations.<\/li>
    • Balanced, yet creative approach to process improvement and problem solving. Thinks critically, uses data/information, creates structure, and keeps the member in mind.<\/li>
    • Develops collaborative relationships with peers, team members, and stakeholders. Viewed as a trusted, inclusive partner.<\/li>
    • Strong technical acumen; learns new systems quickly - e.g. Microsoft Office, clinical documentation platforms, etc.<\/li><\/ul>

      Preferred Qualifications:<\/u><\/strong><\/p>

      • Masters Degree in Nursing or related field. <\/li>
      • Certified Case Management (CCM). <\/li>
      • Formal leadership experience. <\/li>
      • Prior experience identifying and implementing member engagement strategies.<\/li><\/ul>


        a. Provide oversight and lead a member centric clinical and nonclinical teams to support member use and navigation of the health care system in order to promote better health outcomes.b. Provide leadership and day-to-day management of financial and human resources, primarily focusing on employee coaching, development, performance improvement and coordination. Support Wellmark strategies and tactics, business objectives and produce results that are effective, accurate, timely and on target to meet member, business and stakeholder needs.c. Clinical Guidance Serve as a clinical resource subject matter expert for team members and provide guidance in working through complex situations. Ensure processes and programs are focused on holistic coordination of care and are efficient and effective. Collaborate with members/families and their health care delivery team to proactively anticipate health care needs, and create, manage and update individualized, intervention-based care plans. Collaborate with other Wellmark leaders and staff as needed to support a seamless member engagement and experience while ensuring member needs are addressed.d. Develop, implement and maintain effective and efficient policy standards and business processes that support and enhance the clinical team functions and quality of healthcare services. Identify, document and resolve operational barriers that may interfere with the timely, efficient and compliant interactions with members/families and providers.e. Assure processes are in compliance with all accreditation standards e.g. NCQA, UM Kansas certification, local and state regulations, and internal guidelines.f. Lead and/or participate as a subject matter expert in projects related to Health Services programs. Collaborate and participate in joint educational sessions with stakeholders and customers representing Health Services.g. Other duties as assigned.<\/p>


Posted: 2020-05-19 Expires: 2020-06-18

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Tm Ldr Health Services - Care Team

Des Moines, IA 50309

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