Integrated Services Manager
Integrated Services Manager
The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Integrated Services Manager to serve as a liaison to key external county and community partners as well as provides oversight of Managed Long Term Services and Supports (MLTSS) which include community based adult services (CBAS), in-home support services (IHSS), multipurpose senior services program (MSSP), community care settings program (CCSP), and social determinants of health programs
The essential duties and responsibilities will include the following:
- Drive risk stratification and identification efforts within health services to match member level needs with appropriate services and coordination.
- Serves as a clinical expert for complex psychosocial challenges amongst HPSM members.
- Assist with contract monitoring and oversight of MLTSS programs.
- Develop and monitor MLTSS key indicators for quality care and service.
- Analyze outcomes on related MLTSS measures to identify potential barriers, interventions and opportunities for improvement.
- Interface with other teams within HPSM and in the community; plan areas to assure application of policies and procedures and to facilitate interdepartmental and interagency projects.
- Serve as a clinical liaison and help drive service coordination with community partners, such as CBAS Centers, Aging and Adult Services, Institute on Aging, Brilliant Corners, Wider Circle, and others.
- Provide technical assistance to and shape the trainings for Care Coordination and Health Services staff with specific focus on MLTSS benefits and services.
- Coordinate and collaborate with other governmental agencies and community health organizations to promote coordinated care.
- Develop effective comprehensive program designs, standards, and operating procedures; implement and monitor assignments.
- Make decisions on methodologies and procedures for integration of services with external partners to meet governmental requirements.
- Exemplify and promote continuous performance improvement with the LTSS team and Health Services Department.
- Develop appropriate best practices for care coordination services and promote integration of MLTSS services into care continuum.
- Liaison with San Mateo County Health System, its departments, and other community based organizations.
- Accomplish staff results by communicating job expectations; planning, monitoring, and appraising job results; coaching, counseling, and implementing corrective action steps when necessary; developing, coordinating, and enforcing systems, policies, procedures, and productivity standards. Complete performance evaluations in a timely manner
- Perform other duties as assigned
Education and Experience:
Master’s Degree in Social Work - or - Nurse with Master’s Degree in Public Health - or -certification in Case Management. Current and unrestricted RN or LCSW licensure. Minimum of five (5) years of related experience
with at least 2 years in a supervisory or management capacity. Experience establishing and maintaining relationships within the community. At least 1 year of program management experience.
Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access and PowerPoint. Principles, objectives, and techniques of care coordination and case management.
Medicare and Medi-Cal programs. Complexities of working with elderly and developmentally disabled populations. Community organizations and resources. Principles and techniques of interviewing and recording in social casework.
Rules and regulations relating to social services casework. Standards of NCQA and HEDIS. Knowledgeable of applicable laws and regulations
Work cooperatively with others. Work as part of a team and support team decisions.
Communicate effectively, both verbally and in writing. Adapt to changes in requirements/priorities for daily and specialized tasks. Plan, assign, evaluate, and supervise the work of others. Interpret laws and regulations to members and others in the field. Provide consultation to others. Gain consensus on resolution of problems. Present oral and written reports concisely and clearly. Provide excellent customer service; work cooperatively with staff and members of the community.
Compensation and Benefits
Starting Compensation Range: - Depending on Experience
Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s Medical, Dental and Vision coverage. Employee pays a small portion of the dependent premiums (5%) for medical and dental benefits. Additional HPSM benefits include fully paid life, AD&D, and LTD insurance; retirement plan (HPSM contributes equivalent of 10% of annual compensation); holiday and vacation pay; tuition reimbursement plan; onsite fitness center and more.
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