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Clinical Team Leader (NYC/Bronx)

Department: Care Coordination
Reports To: Regional Director

Position Overview:

Provides clinical oversight to support PHPs’ model of care as well as CMS, NYSDOH and
OPWDD contractual agreements. This licensed professional is the point person responsible
for leading a care coordination team and overseeing all care coordination and care
management supports and services to assigned participants. Responsibilities include, but are
not limited to, supervision of assigned Care Managers, oversight of clinical, social, and
functional needs of assigned members; and ensuring compliance with all regulatory
components of FIDA-IDD IDT policy.

Duties and Responsibilities:

  • Utilize a person-centered approach and support participants to be as independent as possible
  • Supervise a team of care managers that are collectively responsible for up to 140 plan participants
  • Provide oversight for all care management supports and services required for their assigned participants
  • Train and coach Care Managers on job duties and PHP policies and procedures
  • Complete probationary and annual evaluations of assigned Care Managers. Assist in hiring process as well as performance improvement, as needed
  • Responsible for timesheets, PTO approvals of assigned staff. Ensure appropriate coverage
  • Conduct regular case reviews and hold bi-weekly supervision with assigned Care Managers
  • Complete Assessments, Life Plans and PHP Risk Assessment in accordance with PHP Policy
  • Lead IDT for high needs, complex cases and in absence of Care Manager. Provides clinical input to IDTs for all participants
  • Audit and approve participant assessments and Life Plans completed by Care Managers; Monitor implementation of Life Plans for all participants
  • Ensure all Life Plans, Assessments and care management notes are completed within PHP policy timeframes
  • Maintain participant Life Plan and health risk assessment information in secure system
  • Provide education to participants, caregivers, circles of support, IDTs, and other stakeholders
  • Conduct in-person visits to participants’ residences as needed
  • Ensure integration of all needed and preferred supports and services (i.e. medical, behavioral health, social, habilitation, dental, psychosocial, and community-based and facility- based long-term supports and services, etc.)
  • Communicate with IDTs, physicians, and other providers at regular intervals to ensure participants’ medical and behavioral needs are met
  • Responsible for hospital discharge planning; preventing hospital re-admissions
  • Responsible for improving health outcomes, and ensuring participants are in receipt of appropriate preventive care relative to health conditions
  • Provide timely preparation and completion of all data entry, data collection, report production completions
  • Provide all verbal, written and electronic communication with participants/caregivers/families, IDT, providers and vendors in a timely manner and accordingly document
  • Maintain participant documents in secure electronic record system and meet all confidentiality requirements
  • Facilitate access to medical providers
  • Adhere to all requirements set forth in the Willowbrook Permanent Injunction as appropriate
  • Complete training necessary to acquire and demonstrate knowledge of the following areas necessary to fully support participants: Physical health, aging and loss, appropriate community support services, frequently used medications and their potential negative side-effects, depression, challenging behaviors, Alzheimer’s disease and other disease-related dementias, behavioral health, and issues related to accessing and using durable medical equipment, as appropriate
  • Flexibility in work schedule is required, with some evening and, or weekend hours as needed • All other duties as assigned


  • Current, active, unrestricted license to practice in NYS as a Registered Nurse, Social Worker, Mental Health Counselor or Psychologist required; and
  • Associate degree in a Healthcare, or Human Service-related field required, with a bachelor’s degree strongly preferred; and
  • Minimum of 1-year experience in at least one of the following areas preferred: o Service provision to people with intellectual and/or developmental disabilities o Case Management with a specialized population OR o Clinical experience in associated field, preferred
  • Supervisory experience preferred; and
  • Strong communication skills including verbal and written communication skills, along with strong interpersonal and organizational skills also required; and
  • Proficiency with health-related computer applications; and
  • Valid Driver’s License to travel within NYS preferred. Must be able to travel and adhere to PHP’s travel policies; and
  • Ability to work remotely if needed while adhering to HIPAA requirements.

Requirements of All Positions:

  • All employees shall meet PHP’s Compliance and Privacy Regulations, and attend at a minimum of one (1) hour of Compliance and Privacy educational training annually;
  • All employees shall master PHP’s Model of Care and complete all training requirements within the first thirty (30) days of employment and annually thereafter, or as required by state and federal regulations;
  • All employees are required to maintain confidentiality, protect privacy, comply with Protected Health Information regulations, and report violations;
  • Perform functions as they relate to “Improving Health Care Quality” as defined in the National Association of Insurance Commissioners Supplemental Health Care Exhibit that:
    1. Improve health outcomes;
    2. Prevent hospital readmission;
    3. Improve patient safety and reduce medical errors, and
    4. Provide wellness and health promotion activities.

Physical Demands and Work Environment:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers, handle or feel utilize objects, tools or controls. The employee is occasionally required to stand; walk; sit; reach with hands and arms; climb or balance; and stoop, kneel, crouch or crawl.

The employee must occasionally lift and/or move up to 25 pounds, and infrequently up to 50 pounds. Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision, and the ability to adjust focus. The noise level in the work environment is usually moderate.

Equal Opportunity Employer

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