Case Management Manager

Advanced Medical Management • Long Beach, CA

5d • $120,000 - $150,000

About The Position

The Case Management Manager is critical to the success of AMM and is responsible for the implementation and ongoing management of all AMM case management programs. The manager will provide guiding principles, interventions, and strategies targeted at achieving client stability, wellness, and autonomy through advocacy, assessment, planning, communication, education, resource management, care coordination, collaboration, and service facilitation. This role reports to the Senior VP of Clinical Operations for operational issues and the AMM or Client Medical Director for clinical issues.

Requirements

• Deep compassion for patients and the care they receive.
• Valid California RN license.
• Bachelor’s degree required.
• Minimum of 5 years of UM and CM experience in an IPA/PMG or HMO setting.
• Experience in management (hiring, counseling, terminations).
• Maintains confidentiality and adheres to HIPAA policies.
• Managerial skills necessary to independently manage on-site as well as remote teams.
• Competent leadership and effective communication style (verbal & written) with proven ability to positively influence behavior and arrive at a “win-win” resolution when possible.
• Strong clinical judgment necessary to interpret and follow medical guidelines.
• Demonstrated skills in resolving complex issues.
• Be courteous and promote professionalism.
• Be flexible and adaptable.
• Promote organizational goals.
• Know and follow safety standards.
• Analytical skills to review and interpret metrics.

Nice To Haves

• Master’s Degree in Nursing or Health – Related Major preferred.
• CCM desirable.

Responsibilities

• Review inpatient cases and provide guidance to IP case managers for reviews, hospital transfers, observation, discharge planning, and transitions of care.
• Review outpatient cases and provide guidance to OP case managers for reviews, case management program overview, and following processes for disease management, complex case management, and DSNP management.
• Inspire the team to develop creative ways to keep patients out of the hospital and ensure the best quality of care at home or in a care facility.
• Lead Monday nurse team meetings.
• Identify, develop, and oversee the educational needs of the team.
• Motivate and lead the team in setting and reaching goals for improvement.
• Work with the team to enhance the systems case management uses.
• Be involved in projects for the platform development for case management.
• Recruit and retain CM team members.
• Conduct annual performance appraisals.
• Provide coaching and disciplinary activities with staff.
• Participate in budget preparation if needed.
• Analyze staffing ratios and productivity levels.

Benefits

• Full employer-paid HMO health coverage.
• Option for a flexible PPO health plan.
• Discounted vision premiums.
• Discounted dental premiums.
• FSAs for healthcare costs.
• FSAs for dependent care costs.
• 401(k).
• Generous PTO.
• 40 hours of sick pay.
• 13 paid holidays.
• Tuition reimbursement.
• Paid company outings.
• Paid company lunches.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager