Hello, we’re Belong.
We partner with regional payers to deliver Medicare Advantage and Special Needs Plan products.With a dual focus on data-driven, proactive clinical intervention and unwaveringly empathetic patient experience, Belong has completely reimagined health insurance for seniors and other Medicare-eligible individuals who have been disregarded and deprioritized for far too long.We believe that only by recognizing individuals can we make communities strong.Belong Health. Kinder, more supportive care.
SUMMARY
The RN Team Lead (DSNP) is responsible for monitoring staff on all aspects of care management for the DSNP line of business. The Team Lead will report to the Director of Care Management. This role oversees staff managing their time and meeting all care management DSNP requirements including assessments, care planning, transition of care needs, interdisciplinary care team meetings, and other care coordination activities. The RN Team Lead - DSNP Team Lead is responsible for assuring the team meets key performance indicators by monitoring, reporting and auditing phone calls and documentation.
You will also educate and coach the staff as well as external providers provider partners on DSNP plans and services available to members and beneficiaries such as social and health support services and community resources.
ESSENTIAL JOB DUTIES AND RESPONSIBILITIES
- Orient new staff members to the Belong Health DSNP programs.
- Provide on-going support to staff related to the programs, care coordination, provider needs and internal customer requests.
- Empower team members to make informed decisions and advocate on their members' behalf.
- Assign and balance caseloads.
- Review reporting for key performance indicators and develop strategies to improve results.
- Organize and maintain employee schedule, payroll duties and one on one meetings with staff.
- Audit employee documentation and phone calls to ensure quality and compliance with policies, procedures and CMS requirements.
- Review employee performance and provide ongoing feedback and development.
- Complete annual performance review cycles.
- Act as the SME for current and future EMR platforms.
- Develop and maintain a collaborative relationship with provider offices, community-based resources, and the entire Belong Health team.
- Participate in cross departmental projects and policy and procedure changes, including coordination of activities and initiatives across departments.
- Promote a culture of accountability and performance to both meet and exceed personal service vision goals and ensure timely and satisfactory resolution of highly complex, specialized, and non-routine customer issues.
- Directly supervise and manage a diverse team of healthcare professionals.
SUPERVISORY RESPONSIBILITIES
This role has supervisory responsibility for the DSNP Care Management team.
REQUIRED PROFESSIONAL EXPERIENCE AND QUALIFICATIONS
Nursing degree with active license in the state of NY (RN).
- Five (5) or more years’ experience in a member services department, health care organization, Community Based Organization, or social services environment.
- Advanced computer skills including ability to work in multiple programs simultaneously.
- Demonstrated ability to work in a fast-paced environment and manage staff to both meet and exceed goals and key performance measures.
- Passionate about customer service with a continuous improvement mindset.
- Excellent problem solving, trend identification, and analytical skills, with a demonstrated ability to problem solve effectively and efficiently.
- Commitment to high ethical standards in all work; protects the privacy of members.
- Excellent oral and written communication skills, including presentation skills.
PREFERRED PROFESSIONAL EXPERIENCE AND QUALIFICATIONS
- Demonstrated progressive leadership experience in a managed care or HMO setting strongly preferred.
- Demonstrated background in a SNP environment strongly preferred.
EDUCATION AND TRAINING
- A undergraduate nursing degree required. Master’s degree in healthcare or nursing preferred.
LICENSE AND CERTIFICATION
- An active, unrestricted nursing license in the state of New York is required.
HEALTH AND SAFETY
Belong Health and its partners require full vaccination for associates and select contractors who conduct work outside of their home on behalf of Belong Health and its partners. This applies to those who work within our facilities; interact directly with members and patients; attend in-person meetings or training; and/or represent Belong Health at events or volunteer activities. Medical and religious exemptions will be considered, and this policy will not supersede state or local laws.
SALARY RANGE
Belong Health is an equal opportunity employer and encourages all applicants from every background and life experience to apply.Our organization participates in E-Verify to confirm the eligibility of employees to work in the United States. (Nuestra organización participa en E-Verify para confirmar la elegibilidad de los empleados para trabajar en los Estados Unidos.)
