Sharp HealthCare

Manager

• Accountable for development and implementation of Hospital Case Management (HCM) and Ambulatory Case Management (ACM) programs
• Manage operations of HCM and ACM departments including Pharmacy, referral management, prior authorization, case and disease care management
• Develop, implement, and update HCM/ACM/Pharmacy policies and procedures in accordance with NCQA, legislative, and health plan requirements
• Provide direct supervision, leadership, mentoring and staff development for HCM and ACM staff
• Coordinate interdepartmental projects and represent SCMG in internal and external quality initiatives
• Ensure regulatory and legislative compliance and timely submission of utilization, case management and disease management work plans
• Develop and manage departmental budgets and identify cost savings strategies
• Implement reporting systems, analyze operational and quality outcome indicators, and report results to Quality of Care Committee

Manager, Integrated Case Management