CDPHP Supervisor, Medicaid LTS and Support Programs in Albany, New York
For more than 30 years, CDPHP has been providing outstanding health care coverage in the Capital Region of New York and beyond. Based in Albany, NY, the physician-guided not-for-profit offers plans in 24 counties. CDPHP cares deeply about the health and well-being of its members as well as its employees. The company values integrity, diversity, and innovation, and its corporate culture supports those values wholeheartedly. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.
Under the guidance and supervision of the Manager of Care Management, the Medicaid Long Term Services and Support (LTSS) Supervisor is responsible for overseeing a team of clinicians who are charged with identifying member and family needs, coordinating care in a cost effective manner and performing utilization management for the LTSS programs.
The Medicaid LTSS Supervisor is responsible for oversight of regulatory requirements for the Medicaid LTSS programs, implementation and oversight of new State required benefits and services. The Medicaid LTSS Supervisor will represent CM and attends meetings for assigned committees, workgroups and teams. Participates in required CM department data collection, documentation audits, reporting and analysis.
Responsible for supervising day-to-day operations, including the staff schedule and caseloads, to ensure appropriate outreach is being made. Provides expertise and staff support for problem-solving complex cases and issues and consults with the Manager/other resources as needed. Collaborates with Manager and participates in staff evaluation and performance activities including hiring, monitoring, coaching, counseling, educating and developing action plans as needed. Develops and supervises new staff orientation plans. Shares responsibility with other CM Supervisors and provides coverage for the Manager's time off as needed. Participates in CM Department quality initiatives. Supports the mission, vision, values and standards of CDPHP.
Associates degree required. Bachelor’s degree preferred.
RN, LPN, or LMSW required
Minimum number years of nursing experience:3
A minimum of one (1) year experience related to care management is required. Experience in a lead capacity is preferred.
Familiarity with the Medicaid LTSS and NYS Waiver Programs preferred.
Familiarity with community resourcesand social service resources to assist patients with social needs preferred.
Experience in home care, medical office setting or managed health plan preferred.
Previous experience working with Facets, Macess, Clinical Care Advance, and Microsoft Office preferred.
Demonstrated understanding of comprehensive care management services is required.
Demonstrated ability to supervise and train staff is required.
Demonstrated ability to execute and support accurate reports on care management activities is required.
Candidate must be able to travel to all CDPHP service area.
As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law.