Assistant Director, Care Coordination - The Health Plan

 
Position: Assistant Director, Care Coordination - The Health Plan

Job ID: 152361

Location: US-TX-Bellaire

Department: STAR KIDS - ADMIN

Talent Area: Professional - Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a - 5p Monday - Friday

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.   To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.

Summary:

We are searching for an Assistant Director of Care Coordination – someone who works well in a fast-paced setting. In this position, you will provide oversight and supervision to the care management staff to deliver exceptional medical management services to members. You will also develop medical management programs in response to the analysis and research of managed care trends and benchmarks to support and develop staff through equitable distribution of resources, assignments, education, and implementation of processes and procedures.

 

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Responsibilities :

Job Duties & Responsibilities

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  • Plan, develop, organize, direct, and implement a coordinated approach to medical management services for members to meet any obligation of contractual agreements and legislative regulations
  • Maintain an adequate level of qualified and competent staff in the department by collaborating with the leadership team in the recruitment and hiring of departmental employees
  • Provide oversight and analysis of care coordination services, evaluation of program offerings, health trends, and complaint findings
  • Routinely assess productivity and accuracy of staff work product to support quality medical management delivery and member support through the health care continuum
  • Develop approaches, policies, and programs for medical management which are based on IDS goals and objectives and meets performance goals
  • Serve as a liaison with community agencies and other groups and organizations that impact member health services
  • Support the delivery of cost-effective, community-based, and culturally sensitive health care through the development of educational and collaboration opportunities to ensure member outcomes that address values of quality, service, and cost-effectiveness


Qualifications:

Skills & Requirements

  • Bachelor’s degree required
  • LCSW, LMSW, or RN certification required
  • Case management certification preferred
  • A minimum of 5 years’ experience in health delivery or in a managed care organization
  • 2 years of supervisory experience required


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