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Manager of Case Management

Company: RCM Healthcare Services
Location: Orange
Posted on: November 3, 2018

Job Description:

Leading managed care organization with a reputation for offering superior specialized service in California is seeking a Manager of Case Management in Orange County, CA.Manager of Case Management???????????????????? Responsible for the daily operations, activities and projects for the Case Management Department.????????????????????? Provide performance management and development of the case management staff to ensure compliance with department policies and procedures along with the implementation of assigned projects.???????????????????? Attend meetings, monitor case management reports, and report to management or committees.????????????????????? Hire, manage, train, review, and set goals for department and staff.???????????????????? Along with the Director, work on the development, implementation and evaluation of the department?s case management policies and procedures.???????????????????? Ensure programs, policies and procedures are in alignment with CMS, DHCS and NCQA standards.???????????????????? Collect, analyze and respond to data regarding overall and individual case management effectiveness.???????????????????? Develop and implement complex project plans which will improve efficiencies, outcomes and satisfaction and which may be directed by federal and/or state regulations.???????????????????? Develop and maintain relationships with providers, networks and groups in order to serve as a liaison between the Health Plan and the provider.???????????????????? Identify cases requiring Director or Medical Director review or intervention and route appropriately.???????????????????? Work in partnership with the other Case Management managers to meet all project deadlines.???????????????????? Maintain department budget.Qualifications:?????????????????????Bachelor?s degree in public health, health care, or related field; or equivalent work experience is required.?????????????????????Master?s degree preferred.?????????????????????Active and unrestricted RN license or LCSW license to practice in the State of California required.?????????????????????5 + years of managed care experience required.??????????????????????5+ years of management level experience required.?????????????????????Active CCM certification preferred.Up to Six Figure Salary with Generous Benefits!!!?

Keywords: RCM Healthcare Services, Orange , Manager of Case Management, Executive , Orange, California

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