Manager, Care Manager

Maryland Care Management Inc•Linthicum, MD

just now

About The Position

This position is responsible for oversight of the planning, development, implementation, and evaluation of Care Management (CM) programs. The Manager of CM is responsible for ensuring staff follow the care management process as defined by improving coordination, continuity, accessibility, and appropriate utilization of healthcare services and community resources for high-risk and special needs members, improving health outcomes and engagement in health seeking behaviors. Maryland Care Management, Inc. (MCMI) manages Maryland Physician Care's (MPC) statewide provider network of hospitals and physicians. Maryland Physicians Care has been providing services to the HealthChoice Medicaid populations since 1996, and we are proud of our footprint in the community. With over 230,000 members, MPC consistently has been one of MD's largest Medicaid-managed care organizations.

Requirements

Current state RN license required.
Minimum of two years of management/supervisory experience required.
Minimum of three years of care management experience required.
Demonstrated skills for presentations and training before small and large groups.
Knowledge of local health care delivery system.
Strong problem solving, organizational, and time management skills with the ability to work in a fast-paced environment.
The ability to successfully utilize Microsoft Office suite and common computer and office hardware is necessary.

Nice To Haves

Bachelor of Science in Nursing (BSN) preferred.
CCM Certification preferred.
Managed Care experience is preferred.

Responsibilities

Provide oversight of care management programs.
Responsible for recruitment and selection of appropriate staff and prepares for timely employee performance evaluations.
Promote individual and team development and provide performance management, when necessary.
Prepare reports on key indicators and activities for committees and senior management.
Collaborate with the Director of CM on development of annual budget and operates within approved budget.
Collaborate with interdisciplinary teams to support staff in coordination of care activities.
Serves as a resource for health plan information and helps to integrate care management functions throughout the health plan.
Assists in the annual development of measurable goals for care management programs based on data from outcomes reports, quality indicators, regulatory agencies, and health plan initiatives and priorities.
Implement ongoing development and education of care management staff.
Ensures that program integrity and regulatory requirements are met in conjunction with the Director of CM.
Other duties as assigned.
Communicates regularly with employees through staff meetings to share company, health plan, and department information appropriate to their job function.
Maintains and promotes patient confidentiality and adheres to HIPAA regulations.
Responsible for development, implementation, and annual review of care management policies and desktops.