Manager Care Management, Senior Care Options South 1

Manager, Integrated Care Management - Nursing

Under the general direction of the Senior Manager or Director, Integrated Care Management - Nursing, the Manager, Integrated Care Management - Nursing, is responsible for day-to-day operations and staff within his / her jurisdiction. The Manager is responsible for implementation, monitoring and oversight of care management functions and programs, including assurance of quality evidenced-based care management practice, adherence to regulatory and accreditation standards; and to delivery of defined metrics to validate business unit / program effectiveness. The Manager, Integrated Care Management - Nursing works collaboratively within Clinical Services and other Point32Health partner departments to identify and address opportunities to improve service, reduce administrative cost and support department, Line of Business (LOB) division, and organizational business goals. The Manager, Integrated Care Management - Nursing is also accountable for recruitment, evaluation, management, and ongoing development, of care management department staff, working in a remote and / or office environment. With his / her Care Management program, support members with chronic condition and complex medical needs including adult, geriatric, and pediatric and high-risk pregnancy. Members are identified as they transition to home following acute care or extended care admissions or emergency room use; in addition, members are referred by providers, self-referral, care givers and predictive modeling.

Key Responsibilities / Duties what you will be doing (top five) :

• Business Process Implementation and Oversight :
• Responsible for implementation and monitoring effectiveness of new and existing Care Management programs, including but not limited to :
• Telephonic care management and onsite transition of care interventions
• Compliance with applicable regulatory and accrediting standards; care management process and interventions consistent with national best practices; demonstrated through scheduled department and quality audits
• Defining and monitoring outcomes and regular reporting for areas of accountability
• Interface with Care Management vendors and programs for bidirectional referrals
• Establishment of written policies and procedures pertaining to Care Management.
• Staff Development :
• Provide direct oversight of coordinators, RN care managers and other interdisciplinary staff working in a remote and / or office-based or hybrid environment. May supervise staff performing member home visits.
• Guide and enhance the core competencies and professional development of reporting staff
• Facilitate and enhance team collaboration to optimize program and member outcomes through integrated services,
• Facilitate collaboration with internal and external stakeholders to maximize partnerships for case management program success, including alignment with provider network and employers
• Serve as consultant and resource for complex situations.
• Resource Management :
• Oversee the management of department human resources related objectives
• Support realization of department administrative budget targets
• Corporate Participation :
• Represent Care Management in relevant corporate teams as required
• Implement and support fulfillment of corporate objectives within jurisdiction
• Other projects and duties as assigned.

Qualifications what you need to perform the job

Certification and Licensure :

Education :

Experience :

Skill Requirements :

Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel) :

COVID Policy :

Please note : We encourage all Point32Health colleagues to follow CDC guidance about COVID-19 vaccines, boosters, isolation, and masking. Point32Health reserves the right to adjust its requirements in response to COVID-19 trends in the communities we serve.

Disclaimer :

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Salary Range :

$104,310.40 - $156,465.60

Compensation & Total Rewards Overview :

The annual base salary range provided for this position represents a range of salaries for this role and similar roles across the organization. The actual salary for this position will be determined by several factors, including the scope and complexity of the role; the skills, education, training, credentials, and experience of the candidate; as well as internal equity. As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company's sole discretion, consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes :

We welcome all applicants and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.