Manager, Care Management Services
Health Plans Inc• US,
•$115,000 - $125,000•Onsite
About The Position
HPI is a respected industry leader with over 44 years of experience, known for its innovation and adaptability. As a third-party administrator, HPI offers a suite of health and benefit solutions to employers. Joining HPI means contributing to ideas that make a real difference for employers and employees nationwide. The company fosters a supportive and inclusive work environment where innovation thrives, investing in team growth and well-being to ensure exceptional service delivery.
Requirements
- Associate’s degree in nursing
- ACTIVE, CURRENT AND UNRESTRICTED REGISTERED NURSE COMPACT LICENSE OR STATE OF RESIDENCY
- 5+ years of clinical experience
- 3+ years’ experience as a Case Manager
- Certified Case Manager (CCM)
Nice To Haves
- Bachelor’s Degree
- Supervisory experience
Responsibilities
- Provide day-to-day oversight of the Case Management program.
- Promote cost-effective management of health resources to meet individual members’ health care needs and promote positive health outcomes.
- Participate in the orientation and mentoring of new employees.
- Perform monthly audits of designated team members.
- Hold monthly 1:1 meetings with designated team members.
- Complete annual performance reviews of designated team members.
- Manage the daily schedule for the CM team, including PTO requests and timesheets.
- Collaborate on a daily basis and as needed with the CM team to balance caseloads, assist in problem-solving and mentoring.
- Collaborate with the Director regarding employee performance issues, escalated member/Case issues, and maintaining up-to-date processes and workflows.
- Communicate with members/designees, physicians, and other healthcare professionals regarding the Care Management process, including information about HPI's role, the Case Management program, policies and procedures, and benefit coverage and determinations.
- Collaborate with other HPI Departments for issue resolution and process improvements as needed.
- Attend meetings as requested by the Chief Clinical Officer or the Director.
- Remain up-to-date on URAC standards and Utilization Management Policies & Procedures.
- Advocate for and promote the case management program.
Benefits
- Medical, Dental and Vision and Prescription Drug Coverage
- Fitness Reimbursement Benefit
- Employee Assistance Program
- Flexible Spending Account & Health Savings Account
- 401(k) and Quarterly Bonuses
- Generous Paid-Time Off & Volunteering Opportunities
- Educational Assistance & Professional Development Opportunities
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
Associate degree
