Manager - Case Management (RN)

Telligen•Oklahoma City, OK

About The Position

As a Quality Improvement Manager - Case Management, you will be responsible for operational management of case management programs, account management, and business development for specific healthcare contracts. Operational management includes team accountability for evaluation measures, deliverables or project requirements. You will be responsible for monitoring compliance in accordance with client and contract deliverables as well as service/accreditation requirements as applicable.

Requirements

Four year degree in nursing, health care, business, public health or a related field and/or equivalent training and/or experience
Graduate of an accredited nursing program (ACEN, CCNE), with an active, unrestricted RN license
5 years experience in a healthcare environment with demonstrated expertise in care management, care coordination, and/health care quality improvement, including experience with case management and evidence-based clinical guidelines
3 – 5 years managing projects and/or a professional staff
Demonstrated experience working in a fast paced and deadline driven environment
Positions working on specific contracts may require U.S. Citizenship.

Nice To Haves

Experience with case management models and interventions
Knowledge of care coordination best practices and transitions of care
Familiarity with population health stratification and risk assessment tools
Understanding of care management metrics and outcomes measurement
CCM (Certified Case Manager) certification or have the ability to obtain certification within 2 years of hire

Responsibilities

Manage the day to day operations of health management lines of service and/or contracts/programs, with particular emphasis on case management programs and care coordination initiatives.
Lead a team in the creation of a strategic plan, implementation of plan, evaluation and ongoing management to ensure contract deliverables/program requirements and evaluation measures/metrics are met and/or exceeded within assigned funding/budget.
Facilitate analyses and initiate action plans when deliverables/requirements are at risk.
Develop and maintain relationships with team stakeholders.
Provide technical assistance, including issue research and resolution.
Develop and implement process improvement methods for an organization whose philosophy is continual improvement.
Ensure operations are completed in a timely, satisfactory, compliant manner within assigned funding/budget.
Participate in sales, business development and proposal work activities including development of concept papers, contributing content or review of proposals as a subject matter expert.
Monitor budgets and financials for assigned contracts.
Coach, guide and direct team members to achieve individual, team and organizational objectives.
Provide resources and support as needed to meet the departmental and Company goals and specific contract/program requirements.
Represent the company and presents at meetings and/or conferences.
Work externally with providers or clients as assigned.
Make recommendations for improvements and/or efficiencies to management.
Initiate opportunities to expand knowledge, skill development, and certifications which enhance quality improvement activities and the achievement of contract deliverables.
Stay abreast of industry trends and changes.
Perform miscellaneous duties as assigned.