Clinical Care Manager
Gold Coast Health Plan
Manager, Clinical Care Management
Gold Coast Health Plan
full-time
Posted on:
Origin: • 🇺🇸 United States • California
Visit company websiteSalary
💰 $110,250 - $183,750 per year
Job Level
Mid-LevelSenior
About the role
- Develop and manage a comprehensive Care Management program to coordinate medical and social services
- Promote positive health outcomes and cost-effective management of health care resources
- Act as advocate and liaison between providers, members and GCHP to integrate complex services
- Develop protocols to review, screen and prioritize cases for case management services
- Develop tools to ensure delivery of comprehensive care management services and auditing methodologies
- Mentor and supervise a large staff of Registered Nurses, Social Workers, and support staff; ensure protocols and workflows are followed
- Identify problems through dialog with staff and implement solutions to improve deficiencies
- Ensure staff inclusion in department decisions and continually reassess staffing needs
- Participate in development of annual Care Management Work Plan and annual evaluation
- Collaborate with community agencies and other Gold Coast departments to resolve resource deficiencies
- Travel to multiple sites and locations; attend evening meetings and work irregular hours as needed
Requirements
- Bachelors Degree required in a clinical area (e.g., Licensed Clinical Social Worker, Registered Nurse, Physical Therapist, Occupational Therapist, Behavioral Health Therapist)
- Masters degree preferred
- 5 plus years of paid experience in clinical specialty dealing with complex patients/members
- 5 plus years of paid experience in managed care preferred
- Active, valid and unrestricted license as appropriate to specialty in the State of California
- CCM or ACM certification required upon hire or within six months of employment
- Proficient in computer programs included in the MS Office products
- Working knowledge federal and state regulations/requirements related to managed MediCal and MediCare
- Extensive knowledge of Care Management Principles
- Strong analytical and problem-solving skills
- Strong organizational and prioritization skills
- Excellent communication skills verbally and in writing
- Ability to travel to multiple sites and locations (up to 75%) and work protracted/irregular hours, including evenings
- Gold Coast Health Plan will not sponsor applicants for work visas (must have work authorization)
