The Senior Clinician reports directly to the Clinical Manager and is responsible for providing first level support to a team of clinicians (SWs/RNs/LPNs). The primary functions are to assist the clinicians by answering questions, offering guidance, and providing “deskside” refresher training. While this position does not have managerial responsibilities, they support the effectiveness and productivity of the team as a subject matter expert and a first level resource for escalated issues. This position is also responsible for being an early adopter of change efforts to provide feedback and support the change effort and adoption by other team members.

• Conducts standard duties and responsibilities of a clinician (Care Manager/ Case Manager/ Clinical Specialist)
• Assists the clinicians by walking the virtual floor and assisting Managers in resolving inquiries.
• Assists the Manager in monitoring logs of open/closed cases to ensure all are handled appropriately and in a timely manner.
• Takes responsibility for complex cases.
• Collaborates with the team to provide input on training to new clinicians. 
• Handles a caseload and works with leadership to test and incorporate new changes and process approaches
• Provide quality oversight in conjunction with Manager; monitoring and coaching to the clinicians to enhance quality and member satisfaction.
• Participates in and assists management with the testing and roll out of interdepartmental campaigns.
• Participates in quality and performance improvement projects, acting as a liaison with management and clinicians as workflow improvements are implemented.
• Comply with HIPAA guidelines and maintain confidentiality of member, provider, medical and departmental information. Adhere to state and federal compliance and regulatory guidelines.
• Identify trends and recommend process improvements.
• Lead team refresher training, as needed, in collaboration with Managers.
• Build sustainable relationships of trust through open and interactive communication with internal and external customers.
• Multi-task, prioritize, and manage time effectively.
• Additional duties as assigned.

Minimum Qualifications:

• At least two years’ experience in Care Manager/ Case Manager/ Clinical Specialist role
• Consistently meets or exceeds current work expectations, applicable metrics, and quality standards set by leadership
• Demonstrates verbal and written communication skills
• Experience handling complex situations and/or projects
• Proficient in Microsoft Office Suite applications including Excel, Word, Power Point, and Outlook.

 Preferred Qualifications:

• Experience with TruCare and/or other similar electronic health record systems
• Understanding of government programs and federal/state guidelines related to utilization management.
• Bachelor’s Degree from an accredited institution
• Working experience using MS Excel to sort, copy and paste, as well as experience creating and using pivot tables.
• Frequently communicates complex information and interacts with management. Can present, resolve conflicts, and address delicate situations.
• Positively drives team culture
• Ability to work flexible hours, weekends, and evenings due to business needs.

Compliance & Regulatory Responsibilities: See Above License/Certification: RN or SW preferred WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved. If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services. EEO Law Poster and Supplement All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst.  Healthfirst will never ask you for money during the recruitment or onboarding process. Hiring Range*:

• Greater New York City Area (NY, NJ, CT residents): $81,099 - $116,480
• All Other Locations (within approved locations): $71,594 - $106,080

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live. *The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.