Member and Support Services Lead - Community Health Care

Polk County•Bartow, FL

15d

About The Position

Must possess the physical, developmental and mental ability to perform job tasks, responsibilities and duties of the job illustrated below: MAJOR FUNCTION Responsible for coordinating and supervising the work of the Customer Service Representatives, Case Managers, and Mobile Outreach Coordinators within the Member and Support Services work unit as it relates to eligibility assessments for the Polk HealthCare Plan, Health Care Responsibility Act (HCRA), Indigent Burials and Cremation authorizations, food bank activities, and other assistance programs. Responsible for coordinating social case management functions. Conducts quality assurance assessments to ensure adherence to policies and procedures. Supervises direct reports. Reports to Community Health Access Manager. ILLUSTRATIVE DUTIES Supervises Customer Service Representatives, Case Managers, and Mobile Outreach Coordinators. Participate in the staff selection process to secure the most qualified staff replacements. Evaluates staff performance and manages personnel actions. Develops, adheres to, and trains team on standard operation procedures. Effectively communicates both verbally and in writing to staff to ensure that expectations are clear. Conducts quality assurance of records to ensure integrity and accuracy of eligibility determination and provide constructive feedback, as necessary. Promote self-sufficiency. Provides input on outposted locations of Case Managers based upon analytical data and community need. Conducts site visits to outposted offices/events of Case Managers and Mobile Outreach Coordinators. Provides case management and determines eligibility, including assisting residents with obtaining necessary forms to achieve desired outcome. Coordinates the client appeal process for program eligibility. Assists with answering phone calls, workload and statistical reports, and performing quality assurance of phone calls. Supervises and manages the process of determining eligibility for qualified indigent out-of-county emergency care in accordance with the Health Care Responsibility Act (HCRA). Collaborate with next of kin, funeral homes for burial or cremation of indigent people/unclaimed bodies found in Polk County. Records all contacts, inquiries, dispositions, and referrals directly into the shared data information system. Maintains confidentiality of all records as required by various laws and statutes, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA) as amended. Reviews, writes, and recommends updates to established policies and procedures. Performs related duties as required.

Requirements

Ability to create a collaborative environment and drive team performance.
Ability to interpret and analyze data for accuracy and quality assurance.
Knowledge of compassionate customer services standards.
Report clear and measurable performance objectives including team productivity, efficiency, and quality.
Ensure Polk HealthCare Plan member and public concerns are addressed in a timely and accurate manner and in compliance with HIPAA regulations.
Delegates and manages staff workload.
Sets performance standards, evaluates staff work performance, and provides timely feedback.
Guides and directs staff to enhance team participation and work development.
Must be a critical thinker, an effective problem-solver, and results oriented.
Ability to manage multiple priorities and meet deadlines in a demanding, fast-paced, rapidly changing environment.
Ability to motivate and develop a supportive work environment.
Ability to communicate effectively and in writing with professional, administrative, and community representatives representing diverse cultures and backgrounds and function calmly in situations which require a high degree of sensitivity, tact, and diplomacy.
Assures staff maintain awareness of community programs, capacities, and future social service developments.
Ability to develop standard operating procedures.
Ability to exercise appropriate judgment in answering questions and releasing information; analyze and project consequences of decisions and/or recommendations.
Skilled in leadership, planning, and organization.
Knowledge of HIPAA privacy and security practices and safeguards.
Knowledge of the Health Care Responsibility Act (HCRA) requirements and procedures.
Demonstrates, self-discipline, dependability, and ethical behavior.
Proficient in Microsoft Office Suite and possess the ability to learn and use new software or other program applications.
Ability to see and write through repetitious use of hands to operate computer and printer/copier.
Ability to stand, bend, walk, squat and twist neck; reach above and beyond shoulder; lifting and carrying filing weighing up to 10 pounds.
Ability to drive to various locations throughout the County.
Graduate of an accredited four (4) year college or university with major course work in Social Work, Sociology, Health Care Administration, or a related field and have a minimum of three (3) years social service interviewing and counseling or related case management experience which includes one (1) year supervisory experience in a social services program.
Must possess a valid driver's license and be able to secure a valid Florida driver's license at the time of employment.
A comparable amount of training and experience may be substituted for the minimum qualifications.
Must undergo a Level 2 (FDLE) screening submitted electronically before commencing work.
Those obtaining this certification must maintain certification as a condition of employment.
All employees will be required to work before, during, or after an emergency.
During an emergency, employees may temporarily be assigned to work and perform duties outside the normal scope of their position, location and work schedule to fit the needs of the County and its residents.

Responsibilities

Supervises Customer Service Representatives, Case Managers, and Mobile Outreach Coordinators.
Participate in the staff selection process to secure the most qualified staff replacements.
Evaluates staff performance and manages personnel actions.
Develops, adheres to, and trains team on standard operation procedures.
Effectively communicates both verbally and in writing to staff to ensure that expectations are clear.
Conducts quality assurance of records to ensure integrity and accuracy of eligibility determination and provide constructive feedback, as necessary.
Promote self-sufficiency.
Provides input on outposted locations of Case Managers based upon analytical data and community need.
Conducts site visits to outposted offices/events of Case Managers and Mobile Outreach Coordinators.
Provides case management and determines eligibility, including assisting residents with obtaining necessary forms to achieve desired outcome.
Coordinates the client appeal process for program eligibility.
Assists with answering phone calls, workload and statistical reports, and performing quality assurance of phone calls.
Supervises and manages the process of determining eligibility for qualified indigent out-of-county emergency care in accordance with the Health Care Responsibility Act (HCRA).
Collaborate with next of kin, funeral homes for burial or cremation of indigent people/unclaimed bodies found in Polk County.
Records all contacts, inquiries, dispositions, and referrals directly into the shared data information system.
Maintains confidentiality of all records as required by various laws and statutes, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA) as amended.
Reviews, writes, and recommends updates to established policies and procedures.
Performs related duties as required.