Manager II Case Management overseeing nurse care managers, ensuring member health care optimization in a collaborative role. Managing quality assurance and mentoring within a hybrid work model.
Responsibilities
Responsible for managing a team of nurse care managers engaged in assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care
Ensuring member access to services appropriate to their health needs
Responsible for process improvement, quality assurance, and adherence to appropriate medical policy
Serves as mentor to lower leveled managers and as subject matter expert for other areas of the company and within the department
Manages multiple functions requiring unique sets of knowledge or has significant fiscal accountability
Develops and manages annual operating budget
Hires, trains, coaches, counsels, and evaluates performance of direct reports
Requirements
Requires BA/BS in a health related field
minimum of 5 years of clinical experience which includes a minimum of 2 years prior management experience
Current, unrestricted RN license in applicable state(s) required
Certification as a Case Manager is preferred
BS in a health or human services related field is preferred
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