Manager, Acute Care Management

SCAN Health Insurance•Long Beach, CA

1d•$92,400 - $133,671•Hybrid

About The Position

The Manager of Acute Care Management is responsible for the leadership, management, and operational oversight of care coordination and case management programs. This role provides direction to clinical and non-clinical staff, ensures effective coordination of member care across the continuum, monitors operational performance, supports quality and regulatory requirements, and promotes effective collaboration with internal and external stakeholders. The Manager is accountable for achieving departmental goals related to service delivery, operational effectiveness, compliance, quality outcomes, and staff development.

Requirements

Active, unrestricted Registered Nurse (RN) license strongly preferred.
Certified Case Manager (CCM) certification or equivalent case management certification preferred.
Licensed Vocational Nurse (LVN) candidates with extensive experience in case management, care coordination, transitions of care, utilization management, or population health management will also be considered.
Demonstrated expertise in managing complex member populations, interdisciplinary care coordination, and healthcare resource navigation is highly desirable.
3-5 years of healthcare, care management, case management, utilization management, or related experience preferred.
2-3 years of leadership experience with direct people management responsibilities preferred.
Experience leading clinical operations, care coordination, case management, or related healthcare programs.
Managed care, Medicare Advantage, health plan, hospital, medical group, IPA, SNF, or post-acute care experience.
Clinical Operations Management – Knowledge of care management, care coordination, utilization management, regulatory requirements, and healthcare delivery models.
Performance & Metrics Management – Ability to analyze operational data, productivity metrics, quality indicators, and trends to drive performance and continuous improvement.
Process Improvement & Workflow Optimization – Ability to evaluate operational processes, identify opportunities for improvement, develop solutions, and implement sustainable changes that improve efficiency and outcomes.
Knowledge of care coordination, case management, healthcare operations, and applicable regulatory requirements.
Skill in analyzing operational data, metrics, and performance indicators to support decision-making and continuous improvement.
Ability to develop, implement, and improve workflows, processes, and operational practices to achieve departmental and organizational objectives.

Responsibilities

Direct and oversee daily care coordination and case management operations, including workload distribution, staff assignments, census management, productivity standards, and escalation processes.
Lead, develop, and manage assigned staff, including recruitment, onboarding, coaching, performance management, corrective action, succession planning, and employee engagement activities. Directly supervises staff and is responsible for hiring, onboarding, coaching, productivity management, performance evaluations, corrective action, employee development, workforce planning, and team engagement activities. Provides leadership and operational oversight for licensed clinical staff.
Provide operational oversight of care coordination activities to support effective transitions of care, discharge planning, complex case management, and member-centered service delivery.
Establish, monitor, and evaluate operational and quality performance metrics, identifying trends and implementing actions to improve outcomes, service levels, productivity, and efficiency.
Ensure compliance with regulatory, contractual, accreditation, and organizational requirements through audits, documentation reviews, staff education, corrective action planning, and ongoing monitoring.
Partner with Medical Directors, providers, hospitals, vendors, and cross-functional business partners to address operational challenges, resolve escalated issues, and support care coordination objectives.
Develop, implement, and maintain policies, procedures, workflows, training materials, and operational documentation to promote consistency, quality, and operational effectiveness.
Lead continuous improvement initiatives through analysis of operational data, identification of opportunities, implementation of solutions, and adoption of innovative technologies and best practices.
Prepare and communicate operational reports, analyses, and recommendations to leadership regarding performance, staffing, quality outcomes, compliance activities, and program effectiveness.
Serve as a subject matter expert for care coordination operations and foster a culture of collaboration, accountability, inclusion, innovation, and service excellence.
Supervises/Manages Others (i.e. hires, performance reviews, corrective action, etc.)
Actively support and advance SCAN’s vision, mission, and strategic goals.
Other duties as assigned.