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Director, Field Service Coordination - Rocky Point

TampaWellCare


Ensures the case management process of assessing, planning, implementation, coordination, monitoring, and evaluating services and outcomes is pursued to maximize the health of the member. Oversees the socio economic needs and services of selected member populations across the continuum of illness.  Takes part in extensive community outreach to garner relationships with key stakeholder groups and organizations.
 
 
  • Manages and develops direct reports who conduct both case management and social service functions within a member's care plan.
  • Sets operational priorities and manages resources to operational goals and budgets. 
  • Proactively monitors appropriate metrics to drive up efficiency.
  • Directs the case management process, providing advice when necessary of complex, controversial and/or unique administrative processes, medical procedures and payment guidelines.
  • Establish, maintain and foster professional working relationships with all providers and community stakeholders.
  • Partners & collaborates with other departments cross functionally regarding care and case management and/or Health Service iniatitives.
  • Manages & resolves e-mails and escalated phone issues in response to provider, staff and other department requests.
  • Directs work assignments, measures results and initiates personnel actions as required.
  • Participates in continuous quality improvement projects that involve case and social service components.
  • Ensure timely and complete delivery of required regulatory reports.
  • Serve on community advisory boards and task forces to address workforce and other long-term care challenges.
  • Ensures compliance with all state and federal regulations and guidelines for all lines of business.
  • Performs other duties as assigned.

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