• Accountable for the day-to-day management of assigned care management teams for appropriate implementation and adherence with established practices, policies and procedures • Participates in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills • Develops, initiates, monitors and communicates performance expectations • Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams • Supports the management of complex physical and behavioral health cases by being clinically and culturally competent with appropriate training and experience • Utilizes critical thinking and judgment to collaborate and inform the care management process in order to facilitate appropriate healthcare outcomes for members • Ensures access to primary care, behavioral health, and coordination of health care services for members as needed • Provides clinical leadership and assists care management staff in supporting members’ understanding of service recommendations based on member need • Conducts regularly scheduled individual and team meetings with a focus on member service delivery, completion of administrative duties, and meeting established productivity standards • Using a holistic approach consults with care managers, medical directors, system of care, social support teams and/or other market staff to overcome barriers to meeting goals and objectives • Identifies and escalates quality of care issues through established channels • Conducts all administrative duties in accordance with established standards for supporting and managing a team • Communicates strategic plan and specific tactics to meet plan needs and ensures implementation of tactics to meet strategic direction for cost and quality outcomes • Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes • Ability to communicate in a highly effective manner with internal and external constituents in both written and oral format • Accountable for meeting the clinical operational and quality objectives of the unit • Consistently demonstrates the ability to serve as a model change agent and lead change efforts • Accountable for maintaining compliance with policies and procedures and implements them at the employee level • Develops and implements processes and resources for providing support to members who opt out of care coordination • Ensures care management/care coordination and disease management are part of population health and quality improvement activities • Ability to evaluate and interpret data, identify areas of improvement, and focuses on interventions to improve outcomes