Case Management Manager

$104,624 - $156,957/Yr

Conifer Value Based Care - Frisco, TX

Full-time - Mid Level

Frisco, TX

1,001-5,000 employees

Professional, Scientific, and Technical Services

About the position

The Manager of Case Management is responsible for overseeing all operational components of case management within the Medical Services department. This role involves planning, directing, managing, and evaluating case management programs to improve the quality of life for members. The Manager supervises both clinical and non-clinical staff and implements collaborative processes for ambulatory case management and transition of care, ensuring that individual health needs are met through effective assessment, planning, and coordination of services.

Responsibilities

• Provides oversight of operational components for case management programs and leads clinical and non-clinical staff.
• Prepares annual evaluations of case management programs, identifying strengths, weaknesses, and opportunities for improvement.
• Reviews clinical and financial outcome data annually and makes recommendations related to ROI.
• Develops work plans for case management in compliance with regulatory agencies.
• Ensures timely submission of required reporting related to case management.
• Identifies program and process improvements for current case and disease management programs.
• Implements case management software and utilizes technology effectively at all levels.
• Acts as a liaison between the Case Management Department and Quality Management Department.
• Prepares necessary reports for appropriate stakeholders.
• Completes special projects as assigned.

Requirements

• Master of Social Work or a related degree.
• 2+ years of case management or formal patient education experience.
• Experience in a managed care environment.
• Prior supervisory or management experience.
• Strong critical thinking and problem-solving skills.
• Excellent communication and organizational skills.
• Ability to work independently and as part of a team.
• Experience with Medical Management platforms.
• Proficiency in MS Word, Excel, and Outlook.

Nice-to-haves

• 5 years of case management or formal patient education experience.
• 2+ years of management experience.
• 5+ years of relevant healthcare experience, preferably in managed care or hospital discharge planning.

Benefits

• 401(k) with 6% match
• AD&D insurance
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount program
• Paid time off (vacation & sick leave)
• Health savings accounts
• Flexible spending accounts
• Voluntary benefits including pet insurance and legal insurance
• Paid leave in accordance with Colorado's Healthy Families and Workplaces Act