Specialist in Credit Card Operations managing account updates and resolving customer inquiries. Compliance with regulations and collaboration with teams to improve process efficiency.
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Hybrid Assistant Manager – Healthcare Operations Management, Case Management Nursing
Posted 3 weeks ago
About the role
- Assistant Manager overseeing day-to-day operations in case management nursing team. Ensure team performance and compliance with Highmark policies.
Responsibilities
- Oversees the implementation of Highmark Clinical Case Management Support including but not limited to Case Management (CM) screening/Telephonic Outreach/Program Enrollment/Task Support for Case Management and monitors daily performance to ensure business goals are met and compliance with Highmark policies and procedures is maintained.
- Implements clinical policies & procedures in accordance with NCQA, URAC, state and federal standards and mandates.
- Serve as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking.
- Ensure implementation and monitoring of best practice approaches and innovations to better address the member's needs across the continuum of care.
- Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
- Manages resources responsible for identification of members, development and implementation of care plans, enhancement of medical appropriateness and quality of care and monitoring.
- Communicates productivity expectations, balance workload (e.g., daily team meetings to discuss new referrals), monitor efficiency and initiate control measures to minimize variances in workload over time.
- Ensures the team's understanding and use of information system capability and functionality.
Requirements
- Active PHRN with minimum 1 year bedside experience.
- Communication Skills Requirement (B2-C1 in HLEAP)
Benefits
- Active PHRN with minimum 1 year bedside experience.
- Communication Skills Requirement (B2-C1 in HLEAP)
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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