Manager Associate Care Management

Elevance Health•San Juan, PR

3d•Hybrid

About The Position

Manager Associate Care Management Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. When reporting to the office, the location is on Carelon Global Solutions Puerto Rico building located on 654 Ave Munoz Rivera San Juan, Puerto Rico. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule: This position will work an 8-hour shift from 8:00 am - 5:00 pm (AST), Monday through Friday. Additional hours, including weekends or holidays, may be required based on operational needs. Carelon Global Solutions (CGS), a fully owned subsidiary of Elevance Health, is a healthcare solutions company that is simplifying complex operational processes to improve the health of the healthcare system. Our Puerto Rico location operates a bilingual Spanish and English call center, providing clear and precise answers to customer queries. The Manager Associate Care Management is responsible of the daily oversight of the program including the overall staff productivity and the allocation of resources for the accomplishment of the Program goals. Manages Nurses and Coordinators.

Requirements

Requires Bachelor degree in Science of Nursing and minimum of 3-5 years experience related to health care fields, disease management, acute care or ambulatory settings, home health care, or managed care setting; or any combination of education and experience, which would provide an equivalent background.
Current Puerto Rico professional license; certification in Disease Management preferred.
Fully Bilingual (English & Spanish). Must be able to write, read and speak both languages in a proficiency level.

Nice To Haves

Experience in a supervisory role in a call center environment is highly preferred.
Previous experience in the healthcare industry preferred.

Responsibilities

Ensure compliance of the daily productivity target of each program and performs weekly report.
Provides operational support on daily issues to the care manager as needed.
Prepares a monthly report of these cases.
Maintains tabulate cases, confirms sent and arrival amount of cases.
F-up on incomplete issues with cases referred according to time frames.
Develops reports of the Programs activities and presents on a weekly basis.
Develop strategies and activities aimed to comply with quality measures established in the contract agreement.
Assists the Medical Manager I in developing special projects.
Performs monitoring of employees telephone ACD activities.
Participate on case discussion sessions, with the multidisciplinary team.
Performs associates' education when is required.
Hires, trains, coaches, counsels, and evaluates performance of direct report.