Summary:

Under the general direction of the Assigned Management, the incumbent oversees the activities of the Community Connections department to ensure efficient and effective uses of company resources, as well as guaranteed service excellence. The Manager oversees the day-to-day operations of the Community Connections functions, investigates and resolves complex member or provider issues. The incumbent provides Community Connections representation at various internal and external meetings, as well as external community events.

Essential Responsibilities/Accountabilities:
• Coordinates operations of staff and training programs.
• Ensures timely and quality care to members regarding health benefit questions and issues.
• Implements and maintains production and quality standards for the Connections program.
• Identifies high risk members and collaborates with case management to strategize outreach to these high utilizers.
• Oversees the processes and auditing of documentation and travel expenses and time and attendance.
• Shadows Community Connection Representatives on home visits and audit results to ensure accuracy and adherence to standards.
• Oversee member Case Management Home Visit outreach and monitor staff outcomes.
• Oversee Health Home Direct Enrollment outreach for qualified members.
• Collaborate with the Health Home Administrators to identify qualified Health Home members.
• Create monthly Health Home Enrollment Tracker reporting for the Health Home Administrators.
• Monitor the safety and location check-ins of staff while in the field.
• Collaborates with Quality Improvement and Case Management Departments on member initiatives and rounds.
• Ensures the development of departmental timeliness metrics and quarterly reports are submitted timely.
• Directs subordinate staff and fosters positive attitudes among staff on quality and safety to ensure that delivered service meets agreed service levels.
• Monitors and evaluates quality of performance and customer service from all work within scope of responsibility.
• Interviews, selects and trains staff to achieve or exceed established standards of performance. Evaluates and appraises performance and make recommendations for merit increases and advancements.
• Plans, schedules, monitors, and reports on activities related to departmental tasks and responsibilities.
• Facilitate Baby Showers in collaboration with case management to educate members and assist with closing gaps on care.
• Secure community partners, venue, and supplies to facilitate community events.
• Coordinates and implements community events, including Birthday Parties, school events, healthy lifestyle events and various community initiatives.
• Collaborate with internal departments within the organization to assist member when needed.
• Manage Community Resource Guide and ensure staff are establishing community resource partners on a regular basis.
• Manage and monitor the SN Food Pantry to ensure adequate quantity and removal of expired good.
• Ensures vision and product is driven and achievable throughout the project and work lifecycle.
• Fosters an environment of continuous improvement. Constantly exploring ways to increase efficiencies and productivity, reducing waste, and reducing costs.
• Facilitate monthly one-on-ones and quarterly check-in's with team members.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct and Leading to the Lifetime Way values and beliefs.
• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
• Maintains knowledge of all relevant legislative and regulatory mandates and ensures that all activities are in compliance with these requirements.
• Conducts periodic staff meetings to include timely distribution and education related to departmental and Ethics/Compliance information.
• Regular and reliable attendance is expected and required.
• Performs other duties and functions as assigned by management.

Minimum Qualifications:
• Bachelor's degree in related field. Bilingual experience preferred
• Minimum of 4 years of member services, social services, community outreach, or education experience
• Demonstrated leadership skills
• Demonstrated skills in forming and fostering high performance, cross-functional teams
• Demonstrated knowledge and experience of health insurance industry and Health Plan business
• Highly Effective communicator
• Demonstrated skills in quality principles, especially root cause analysis and problem solving
• Demonstrated competence in staff leadership and project leadership tasks
• Demonstrated skills in conflict resolution
• In-depth knowledge of management structures and reporting procedures
• Acts professionally at all times and encourages professional standards among staff

Physical Requirements:

• Required to travel independently throughout the health plan regions

The Lifetime Healthcare Companies aims to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.

Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture. We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services. With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.

OUR COMPANY CULTURE:

Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and

qualifications deemed essential to the position.

Equal Opportunity Employer

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)