Manager Of Care Management

Overview

• Lead care management operations, ensuring compliance with regulatory standards and organizational goals.
• Collaborate with leadership to develop care management models and policies.
• Supervise staff to drive high-quality outcomes and member satisfaction.
• Ensure timely access to services for members and adherence to regulations.
• Provide strategic direction and accountability for care management operations.
• Develop and implement policies and procedures to enhance care management.
• Work in a hybrid environment with flexible office attendance requirements.
• Opportunity to contribute to innovative healthcare solutions.

Key Responsibilities & Duties

• Supervise day-to-day care management operations and staff activities.
• Ensure alignment of practices with strategic goals and regulatory compliance.
• Provide leadership and guidance to care management teams.
• Develop and apply care management policies and procedures.
• Monitor and enhance workflow processes for optimal efficiency.
• Collaborate with leadership to achieve high-quality outcomes and satisfaction.
• Ensure compliance with Medicare and regulatory requirements.
• Perform additional duties as assigned to support organizational goals.

Job Requirements

• Associate of Applied Science (AAS) degree required.
• Minimum of 1 year of experience in care management; 3-5 years preferred.
• Current NYS RN license or social worker qualification preferred.
• Experience within a Managed Care Organization is highly desirable.
• Strong knowledge of Medicare regulations and compliance standards.
• Proven leadership and team management skills.
• Ability to develop and implement care management policies effectively.
• Excellent communication and collaboration abilities.