Manager, Clinical Care - Remote

Overview

The Manager, Clinical Care is primarily responsible for the day-to-day operations of an integrated multi-disciplinary clinical and clinical support structure that will effectively monitor, support, and lead Value Based clinical initiatives.

In Short

• Effectively managing Health Plan Clinical Programs to enhance clinical efficiencies.
• Identifying opportunities for increased outpatient vs. inpatient utilization.
• Utilizing data to manage population health needs and implement programs for beneficiaries.
• Executing case management for high-risk patients to decrease unnecessary emergency visits.
• Overseeing an extended patient care team including Social Workers and Liaisons.
• Ensuring smooth Transitional Care Management for discharged patients.
• Implementing Health Education Activities for beneficiaries and providers.
• Participating in Care Coordination and Quality Committees.
• Managing departmental expectations including staff hiring and performance improvement.
• Monitoring compliance with HIPAA regulations and health plan audits.

Requirements

• RN/BSN required.
• 5 years of management experience.
• 4 years clinical nursing experience.
• 4 years of chronic care case management experience.
• Certification in case management preferred.
• Must be able to work remotely and obtain state licensure in IL, GA, PA, and TX.
• 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 options.
• Employee Assistance Program (EAP).
• Flexible Time Off.
• Paid parental leave.
• Professional growth and development resources.