Director, Care Coordination - Idaho Residency Preferred

Idaho residency preferred.

Maintains operational accountability for care coordination, case management, integration with physical health plan and health promotion functions to achieve the business and clinical outcomes for the health plan, meeting contract requirements. Directs all care coordination activities ensuring delivery is consistent with model of care, approved program descriptions and meets state, National Committee of Quality Assurance (NCQA) accreditation standards, Centers for Medicare and Medicaid Services (CMS), and other applicable standards and requirements.

• Plans, implements, directs and provides leadership and oversight of the clinical and care coordination operational processes and staff. 
• Actively participates in cost of care and medical action plan activities. 
• Actively participates in regulatory, quality management, performance management and accreditation activities. 
• Acts as Subject Matter Expert for case coordination and care management programs that care coordination and care management team activities meet the standards required for the state, NCQA, CMS and other accreditation and oversight entities. 
• Directs, coordinates and oversees the evaluation of efficiency and productivity of care coordination functions, including complex case management, chronic disease programs, health promotion for physical and behavioral health as well as the work of peer support specialists and health guides.
• Assures staff selection, training, and evaluation to promote the development of a high-quality team.
• Collaborates and coordinates with departmental managers to integrate and communicate with and across the utilization management and quality programs.
• Participates in the evaluation of the care coordination program against quality and utilization benchmarks and goals.  Identifies opportunities for improvement.
• Works closely with and provides input to national health plan clinical team on program design, policies, procedures, workflows, and correspondence.
• Collaborates with leaders in Network, Community Liaison, Quality Improvement, Customer Service and Finance to assure a comprehensive approach to managing quality of care, service and cost of care.

Other Job Requirements

Responsibilities

7+ years of clinical experience.

Minimum of 3 years' direct supervisory experience including responsibility for analyzing complex datasets that may include cost of care results, cost of care opportunities, quality measurement and performance metric development and achievement.

Must have 2+ years' experience in care coordination and case management operations.

General Job Information

Title

Director, Care Coordination - Idaho Residency Preferred

Grade

30

Work Experience - Required

Clinical, Managed Healthcare, Management/Leadership

Work Experience - Preferred

Education - Required

Bachelor's - Nursing, Bachelor's - Occupational Therapy, Bachelor's - Physical Therapy, Master's - Behavioral Health

Education - Preferred

License and Certifications - Required

BCBA - Board Certified Behavior Analyst - Care Mgmt, LCMFT - Licensed Clinical Marriage and Family Therapist - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, LMHP - Licensed Mental Health Professional - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, OT - Occupational Therapist, State Licensure - Care Mgmt, PT - Physical Therapist, State Licensure - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt

License and Certifications - Preferred

Salary Range

Salary Minimum:

$105,230

Salary Maximum:

$178,890

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.