Manager, Care Management

Summary/Position Objectives:

This position is responsible for oversight of the planning, development, implementation, and evaluation of Care Management (CM) programs. The Manager of CM is responsible for ensuring that staff follow the care management process as defined, which involves improving coordination, continuity, accessibility, and the appropriate utilization of healthcare services and community resources for high-risk and special needs members. This process aims to enhance health outcomes and engagement in health-seeking behaviors. 

What You'll Do:

• Provide oversight of care management programs.
• Responsible for recruitment support and selection of appropriate staff, and prepares for timely employee performance evaluations.
• Prepares reports on key indicators and activities for committees and senior management.
• Collaborates with the Director of CM on the development of the annual budget and operates within the approved budget.
• Collaborate with interdisciplinary teams to support staff in the coordination of care activities.
• Serves as a resource for health plan information and helps to integrate care management functions throughout the health plan.
• Assists in the annual development of measurable goals for care management programs based on data from outcomes reports, quality indicators, regulatory agencies, and health plan initiatives and priorities.
• Ensures that program integrity and regulatory requirements are met in conjunction with the Director of CM.

Secondary Functions:

• Communicates regularly with employees through staff meetings to share company, health plan, and department information appropriate to their job function.
• Responsible for development, implementation, and annual review of care management policies and desktops.
• Maintains and promotes patient confidentiality, adhering to HIPAA regulations.
• Works in a manner that is not disruptive to peers, supervisors, and/or subordinates. 
• Other duties as assigned. 

Knowledge and Skills:

• Demonstrated skills for presentations and training before small and large groups.
• Knowledge of local health care delivery system.
• Strong problem-solving, organizational, and time management skills with the ability to work in a fast-paced environment.
• The ability to successfully utilize Microsoft Office suite and common computer and office hardware.

Education and Work Experience:

• Registered Nurse with current State license (in good standing)
• Graduate from an Accredited School of Nursing with a Bachelor of Science in Nursing (BSN) 
• 2+ years of management/supervisory experience
• 2+ years of clinical nursing in an acute care or community setting
• 3-5 years of OB experience
• CCM Certification (preferred)

Positions Reporting:

Care Managers

Community Health Workers