Manager – Care management
NO WEEKENDS, NO CALL, 100% REMOTE WITH 50% FIELD TRAVEL
This individual ensures the delivery of high-quality services in compliance with all state, program, and accreditation requirements.
This individual will manage a team of clinical and non-clinical care managers, providing case management services across the continuum of care (assessment, care planning, care coordination, and monitoring and evaluating services). In collaboration with key stakeholders, this individual will create action plans in support of quality improvement efforts and positive health outcomes.
What You Will Do:
- Lead and manage a team of clinical and non-clinical care managers to engage, motivate, and educate family caregivers to support complex individuals, keeping care at home.
- Oversee care management functions and ensure consistency and compliance with clinical policy, procedure and best practices, including regulatory and contractual agreements as well as NCQA accreditation requirements
- Lead, coach and develop staff to meet department goals, ensuring key performance indicators and goals are reviewed regularly in support of a high performance / high engagement work environment
- Plan, organize, and oversee timely completion of activities, including assessments, care plans, and discharge planning
- Implement and interpret organizational and contractual policies and procedures; regularly review work to ensure policies and guidelines are appropriately applied
- Track and trend outcomes for potential improvements in the care management process. Create monitors, evaluate and disseminate programmatic reports weekly, monthly, and as needed
- Provide oversight for the appropriate use of tools and person-centered care plans to support caregiver and care recipient needs; provide regular review of incidents to identify cause and recommend interventions
- Support and maintain clinical relationships with key external business partners and referral sources to increase care collaboration and foster credibility in our services
- Review and analyze data (e.g. hospitalization rates, falls, incidents, activation, suspension, and discharge rates) and engage care management team to determine improvement opportunities and manage interventions
- Perform other duties and special projects as assigned
What You Will Bring:
- Bachelor’s degree or equivalent, preferably in a health care or social services discipline is required
- 7+ years of case management experience in healthcare and social services, preferably with experience in eldercare, and/or people with disabilities or other complex medical needs
- 3+ years of experience managing, coaching or developing staff; 2+ years of program or clinical operations management
- An active RN license is required.
- Ability to travel (usually by automobile) within assigned geographic area; valid driver’s license and automobile insurance is required
- Working knowledge of case management systems, community service and delivery systems, and proficiency with Microsoft Office suite.
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