ConcertoCare

Manager, Case Management

ConcertoCare

full-time

Posted on:

Origin:  • 🇺🇸 United States • California, Washington

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Salary

💰 $125,000 - $135,000 per year

Job Level

Mid-LevelSenior

About the role

  • Supervises day-to-day performance of Lead Case Manager and Case Managers in their assigned markets.
  • Oversee job performance, provide regular feedback to Lead Case Managers and Case Managers, perform mid-year and annual performance reviews.
  • Manages goal setting, performance improvement, and expectation management across the team.
  • Ensures Case Managers in assigned region are trained and performing their work in accordance with ConcertoCare’s Care Model.
  • Responsible for staff growth and development by identifying skill and knowledge development to allow staff to grow professionally and advance in their career at ConcertoCare should they desire.
  • Manages recruitment, selection, and orientation of new staff as well as on-going training, mentoring, and completion of timely performance reviews.
  • Keeps VP of Case Management informed of market and individual case manager performance not meeting ConcertoCare targets/goals or identified opportunities for improvement.
  • Leads and participates in the ongoing improvement of the case management process, roles, and documentation requirements for Case Managers and other team members involved with case management activities.
  • Works collaboratively with the VP of Case Management to support goals and objectives for case management, and implements strategies for tracking, reporting, and achieving established goals.
  • Ensures high quality and timely implementation and documentation of activities performed by RNCMs in their assigned geography per polices & procedures.
  • Leads and participates in cross-functional project teams and serves as the Case Management subject matter expert to improve ConcertoCare’s processes and programs.
  • Partners with IT and other corporate teams to support special projects , improve case manager clinical documentation in the electronic medical record, reports and dashboards as the Case Manager subject matter expert.
  • Generates and analyzes reports and monitors performance against goals for assigned markets in their region.
  • Monitors and manages case management reports and dashboards for staff performance, provides guidance and implements actions as needed to achieve ConcertoCare’s internal goals and contractual obligations.
  • Supports customer success through leading and participating in external meetings with payer case management teams, external provider partners, and community resources/ vendors
  • Manages and aggregates patient and case management data, creates presentations for internal and external partners. Example: Case Manager Clinical Case Conferences for external partners.
  • Assumes caseload of patients and manages care, as needed, in accordance with the job duties of Case Managers as needed
  • Travels periodically to assigned markets for market meetings, new market startup activities, or targeted other meetings
  • Other duties as assigned.

Requirements

  • Current RN License in good standing in the state of practice required.
  • Bachelor's degree in nursing highly preferred.
  • Active RN licensure with other clinical or business bachelor’s degree considered as a minimum
  • Certified Case Manager (CCM) certification or CCM eligible with commitment to completion within 1 year of hire
  • Minimum of 5 years’ experience working in a clinical setting, with at least 3 years of case management experience in home health care, ambulatory care, community public health, and/or the insurance setting
  • At least 2 years' experience leading teams, ideally in geographically distributed or remote models
  • Ability to train, educate, mentor, and support others in their professional development as Case Managers and Lead Case Managers
  • Audit experience highly desired
  • Detail oriented, with strong problem-solving and organizational skills
  • At least 2 years working with data and reporting, with preference for those with productivity and outcomes tracking experience
  • Geriatric care experience highly desired
  • Broad knowledge of health care delivery/managed care regulations , contract terms/stipulations, prior utilization management/case management experience, and governmental home health agency regulations
  • Knowledge of Medicare and Medicaid regulations and insurance benefits preferred
  • Delegation experience preferred
  • Strong clinical skills and ability to implement evidence-based care
  • Ability to manage patient complexity and multiple clients with diverse needs
  • Demonstrated ability to guide staff through patient triage process and identified need for escalation to internal and external interdisciplinary team members and apply critical thinking skills
  • Ability to communicate effectively in writing and verbally
  • Highly professional, and able to respond effectively to rapidly changing circumstances both internally and externally to the ConcertoCare organization
  • Demonstrated ability to perform multiple concurrent tasks with minimal supervision and meet deadlines.
  • Ability to work in a fast-paced, dynamic environment and work well with others on a team.
  • Proficient in computer skills to include Microsoft Office Suite (Outlook, Excel, PowerPoint, Word) as well as clinical documentation systems such as EMRs strongly preferred
  • Experienced and proficient with data analysis, data driven decision making, issue identification and tracking, and project management
  • Knowledge and ability to navigate internet-based tools and applications, and proficient in computer documentation