CCCM Kidney Care Team Lead

The Kidney Care Team Lead will have direct supervisory responsibility for CCCM Kidney Care activities on designated kidney care cases and serve as a primary resource for CCCM Kidney Care team. The Team Lead will also serve as a delegate for any duties assigned by the Director of Population Health Management related to CCCM Kidney Care cases.

CCCM Kidney Care Team Lead: ESRD will remain available as a clinical resource to all Renal nurses regarding questions about case handling procedure and customer relations. Intervene in any CCCM Kidney Care Case Conflict or complaints which cannot be handled satisfactorily by the Kidney Case Manager. Work with the director of population health in the development of any enhancements to the CMS Module. Keep abreast of advances in clinical areas, including but not limited to, surgical procedures, drugs, medical devices, and experimental procedures as they impact the kidney care program. The Team Lead: The Kidney care team lead will practice within the scope of his/her licensure. Assess problems and determine goals and actions designed to meet the needs of the patient and document into the case notes. Determine if these goals are long term or short term and how the patient can be expected to meet those goals. Contact the payer office to find out and understand any benefit constraints that will have an impact on the plan of action if assistance is required by the primary CM. Make care arrangements for quality patient care according to the needs of the patient, the physician’s orders and benefits available. Consult with the Director of Population Health Management, on a regular basis, and keep the supervisor informed regarding any complaints which may occur about Care Management Services. Serve as a Point Person for Staff in the absence of the Director of Population Health. Adhere to all Company Policies as stated in the employee handbook. Participate in the Quality Management Program by adhering to all company policies and procedures and identifying opportunities for improvement to ensure quality services are rendered to clients and customers. Department Management: Maintain open lines of Communication with the Director of Population Health Management and other department supervisors to exchange ideas and avoid conflict. Assign newly referred cases to Kidney Case Managers, basing the assignment on acuity of the patient and case load and competency of the Case Manager. Attend Care Management meetings on Scheduled dates. Participate in URAC desktop and re-accreditation activities as needed. Adhere to all company policies as stated in the employee handbook. Maintain a case load. Keep abreast of URAC changes, recommending necessary policy and procedure changes to be in compliance with regard to Kidney care cases. Team Lead, who shall remain a resource to other Case Manager’s, shall possess a URAC – recognized Case Manager Certification. Client Relations/Problems Solving: Maintain an ongoing professional relationship with customer contacts to facilitate confidence in MedWatch services. The incumbent may be responsible for duties or responsibilities that are not listed in this job description