Tailored Care Management Lead
DataStaff, Inc is seeking a Tailored Care Management Lead for a long-term contract opportunity with one of our direct clients located in Raleigh, NC
Job Description:
Program Manager, TCM Program Lead - Population Health will:
- Support TCM policy updates and communication plan for notifying stakeholders of policy changes for Provider Certification, TCM program updates and changes.
- Support provider education with certification, recertification as well as adding and removing population segments.
- Support the development and monitoring of Care Management monitoring protocols.
- Support the development of the TCM and AMH Health Home SPAs
- Contribute to the design of policy that supports members’ choice of Tailored Care Manager provider.
- Lead stakeholder education efforts to support High Needs Members.
- Lead stakeholder education efforts to support advisory groups and community stakeholders.
Skills:
- Demonstrated experience in population health models, care delivery/care management models, clinical program innovations,
- Broad knowledge of health insurance, operations, programs, and policy and procedure.
- Understanding of system design and implementation of program requirements and business processes.
- Ability to interpret complex data/datasets and other information and communicate trends and probable outcomes.
- Experience researching and implementing federal and/or state laws and regulations.
- Excellent critical thinking, problem-solving, and project management skills.
- Demonstrated ability to communicate complex material in a clear and concise manner both verbally and in writing.
- Demonstrated skills in establishing and maintaining strong collaborative working relationships with internal and external stakeholders.
- Strong proficiency in Microsoft Office products including Excel, Outlook, PowerPoint, and Word.
- Demonstrated ability to multitask with little supervision and flexibility to adapt to shifting priorities and short-term deadlines.
Expectations in the form of Goals and Tasks:
- Lead TCM Provider Certification Program.
- Lead Program Policy document Updates (example TCM Provider Manual).
- Create TCM Provider Surveys to understand areas for TCM Program improvement/education.
- Support TCM Provider education efforts to drive positive member outcomes.
- Lead efforts to identify and mitigate TCM Provider Administrative burden.
- Lead process to resolve CMA/AMH+ Administrative Site issues, preserving member TCM assignment.
This opportunity is available as a W2 position with a competitive benefits package. DataStaff, Inc. offers medical, dental, and vision coverage options as well as paid vacation, sick, and holiday leave. As many of our opportunities are long-term, we also have a 401k program available for employees after 6 months.