Manager, Clinical Care Case Management - Remote

Overview

The Manager, Clinical Care is responsible for overseeing day-to-day operations of clinical initiatives, focusing on value-based care, case management, and care coordination.

In Short

• Manage Health Plan Clinical Programs to enhance clinical efficiencies.
• Identify opportunities for outpatient utilization.
• Utilize data for managing population health needs.
• Execute case management for high-risk patients.
• Oversee a team including Social Workers and Liaisons.
• Ensure smooth Transitional Care Management for discharged patients.
• Review Quality Measures and implement Health Education Activities.
• Participate in Care Coordination and Quality Committees.
• Manage departmental expectations and staff performance.
• Ensure compliance with HIPAA regulations.

Requirements

• RN/BSN required.
• 5 years of management experience.
• 4 years clinical nursing experience.
• Experience in chronic care case management.
• Certification in case management preferred.
• Ability to work remotely and obtain state licensure in multiple states.
• Strong leadership and interpersonal skills.
• Ability to analyze complex documents and respond to sensitive inquiries.

Benefits

• Fully remote work environment.
• Comprehensive Medical, Dental, and Vision plans.
• 401(k) plan with employer match.
• Life and Disability insurance.
• Employee Assistance Program (EAP).
• Paid time off for work-life balance.
• Paid parental leave.
• Resources for professional growth and development.