Manager I – Maternal, Child, and Women’s Health Care Management
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Woodland Hills • California • Nevada • United States
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Salary
💰 $90,960 - $163,728 per year
About the role
- Managing a team of physical and/or behavioral health practitioners responsible for coordinating member service, utilization, access, care management and/or concurrent review
- Ensuring compliance with global program elements as well as contractual or regulatory requirements
- Developing and implementing workflows and protocols in compliance with global programs and regulatory guidelines
- Assisting in identifying opportunities to improve operational efficiencies, clinical quality, and solution performance
- Analyzing solution specific reports identifying trends over time
- Coordinating service delivery to include member assessment of physical and psychological factors
- Partnering with providers to establish short and long-term goals that meet the members’ needs, functional abilities, and referral sources requirements
- Identifying members with potential for high-risk complications
- Reviewing benefit systems and cost benefit analysis
- Evaluating medical, mental health and substance abuse service for cost containment
- Supporting program compliance and assisting in identifying opportunities to improve the customer service and quality outcomes
- Supporting quality initiatives and activities, including adherence to National Committee for Quality Assurance (NCQA) standards and HEDIS reporting
- Hiring, training, coaching, counseling, and evaluating performance of direct reports
Requirements
- Requires BA/BS and minimum of 5 years of experience in Health Care Management
- Current active unrestricted RN and any other state or federal requirements that may apply is required
- MSN, MPH, MPA, MSW or MBA with Health Care Concentration preferred
- Prior bedside obstetric, pediatrics, and/or women's health experience is preferred
- Prior experience in Care Management
- Prior experience in managing or leading a team or project management is necessary to ensure exceptional attention to detail and an understanding of clinical operations is preferred
- Excellent written, oral, presentation, and interpersonal communication skills are strongly preferred
- Proficiency in Microsoft Office products—Excel, Teams, Outlook, PowerPoint, Word—and AI tools is strongly preferred
- Licensure in CA, NV, and/or WA is preferred
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
- paid holidays
- Paid Time Off
- medical
- dental
- vision
- short and long term disability benefits
- wellness programs
- financial education resources
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Health Care ManagementCare ManagementCost Benefit AnalysisClinical Quality ImprovementOperational EfficiencyQuality AssuranceHEDIS ReportingMember AssessmentRisk IdentificationWorkflow Development
Soft Skills
LeadershipCoachingCommunicationInterpersonal SkillsAttention to DetailTeam ManagementProblem SolvingTrainingCounselingPerformance Evaluation
Certifications
RN LicensureBA/BS DegreeMSNMPHMPAMSWMBA with Health Care Concentration