ICM Team Lead

Following a 2022 merger of CNSI and Kepro, Acentra Health combines clinical services, technology solutions, and data analytics to accelerate better health outcomes. This is a great time to join our team of passionate individuals working together to pursue the most effective solutions to today’s complex healthcare challenges. Our culture is fueled by passion and driven by purpose.

Intensive Care Manager (ICM) Team Lead

·      Are you an experienced ICM Team Lead looking for a new challenge?

·      Are you looking to join a team that ensures a collaborative and inviting culture where everyone can thrive?

If so, you might be our next new team member!

Who we need:

Our ICM Team Lead Partners with Independent Assessment, Certification & Coordination Team (IACCT) Manager with daily operations of the VA (DMAS)Behavioral Health and Specialty Services contract ensuring quality, productivity & compliance in accordance with contract deliverables. Utilizes clinical expertise for the review of medical records against appropriate criteria in conjunction with contract requirements, critical thinking, and decision-making skills to determine medical appropriateness, while maintaining production goals and QA standards. Ensures day-to-day processes are conducted in accordance with VA(DMAS) Business Rules, VAC, CMS, URAC, ERISA/DOL and ACA requirements/guidelines and timelines. Performs quality monitoring/audits activities. Performs all the duties related to the Intensive Care Manager (ICM) Role.

Why us?

 We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

Singularly Focused. Mission Driven. 

Accelerating Better Outcomes is our Mantra! We are mission-driven to innovate health solutions that deliver maximum value and impact. 

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits are a key component of your rewards package. Our benefits are designed to provide you additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more. 

What you’ll do:

·      Maintain a minimum of 75% of the required productivity requirements.

·      First in line for questions prior to escalation to IACCT Manager.

·      Responsible for the quality monitoring/audits activities including identifying areas of improvement, plan implementation of improvement areas, and staff training. 

·      Under the direction/guidance of director/operations manager manages, reviews and reports outliers to establish timely quality improvement initiatives.

·      Assess and evaluate the daily work queues throughout the day to ensure cases are completed timely.

·      Assist and provide input to the IACCT Manager and Director with updating and creating job-aids as needed.

·      Reviews and interprets patient records and compares against criteria to determine medical necessity and appropriateness of care; determines if the medical record documentation supports the need for services.

·      Supports IACCT Manager with determining approvals or initiates a referral to the physician consultant and processes physician consultant decisions ensuring reason for the denial is described in sufficient detail on correspondence.

·      Abstracts review related data/information accurately and timely on appropriate review tool by the appropriate means. Accurate and timely submission of all administrative and review related documents to appropriate parties.

·      Leads and performs ongoing reassessment of review process to offer opportunities for improvement and/or change.

·      Foster positive and professional relationships and act as liaison with internal and external customers to ensure effective working relationships and team building in order to facilitate the review process.

·      Always maintains medical records confidentiality through proper use of computer passwords, maintenance of secured files, adherence to HIPAA polices.

·      Utilizes proper telephone etiquette and judicious use of other verbal and written communications, following Acentra