Director, Care Management - Foster Care

Centene Management Company•Oklahoma City, OK

4d•Hybrid

About The Position

Directs the care management team and the care (management) of members to develop and assess high quality, cost-effective healthcare outcomes. Develops strategies and objectives within care management to improve member and/or provider experience. Key Details: Must reside within Oklahoma or be willing to relocate. Onsite meetings at the Oklahoma City office.

Requirements

Requires a Bachelor's degree and 7+ years of related experience, including prior management experience.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
Oklahoma Registered Nurse (RN) license or Compact Registered Nurse (RN) license and nationally recognized case management certification required

Responsibilities

Directs and evaluates departmental operations, including the care management model, staffing, use of information technologies, and staff competencies to achieve performance and quality objectives
Oversees care management team on performance, improvement, and talent management
Sets goals and objectives for care management team and oversees care management data and reporting metrics to achieve quality and cost-effective healthcare results and working with senior leadership, as required
Oversight of the development and implementation of care management policies and procedures within the care management team to ensure compliance with regulatory requirements for federal, state, and National Committee for Quality Assurance (NCQA) standards, as required
Stays up to date on latest trends and best practices in Payer Care Management and related fields and attends conferences, as required
Leads process improvements for the care management team to achieve quality and cost-effective healthcare results and working with senior leadership, as required
Contributes to the development and improvement of clinical care pathways that enhance cost effectiveness while providing quality care
Develops care management strategies and influences decisions by providing recommendations that align to organizational objectives
Develops department budget while collaborating inter-departmentally and with senior leadership
Develops the overall strategy for onboarding, hiring, and training new care management team members to ensure adequate training and high quality-care to improve member and/or provider experience and ensure compliance
Performs other duties as assigned.
Complies with all policies and standards.