About The Position

Responsible for managing and coordinating the patient care transitions program. This ensures the patient's progression through the care continuum in a manner that achieves designed clinical and financial outcomes. Participates in the system development and implementation of integration of care transitions along the continuum of care. Works in close collaboration with the multidisciplinary team, in all settings to include ambulatory, post - acute providers and health plans. Serves as mentor by role modeling a professional practice consistent with organizational goals, customer service, clinical effectiveness, and standards of care. Responsible for developing and managing the departmental budget, compliance to federal, state and regulatory requirements. Manages the DSNP team with oversight of Medicare and Medicaid requirements Oversees contractual compliance and NCQA requirements Leads 5 direct reports (supervisors) and 66 indirect reports, including care coordinators, ICMs, and LCSWs, etc.

Requirements

  • Bachelor’s Degree REQUIRED
  • One of the following is REQUIRED: Registered Nurse License (RN) - Nursing License - Compact/Multi-State License or Licensed Clinical Social Worker (LCSW) - State license - North Carolina Social Work Certification and Licensure Board (NCSWCLB) or Qualified Mental Health Professional (QMHP) - State License - Virginia Department of Health Professionals (VADHP) or Licensed Clinical Mental Health Counselor (LCMHC) - State License - North Carolina Board of Licensed Clinical Mental Health Counselors (NCBLCMHC) or Licensed Professional Counselor (LPC) - State license - Virginia Department of Health Professionals (VADHP) or Licensed Professional Counselor (LPC) - State license - North Carolina Board of Licensed Clinical Mental Health Counselors (NCBLCMHC)
  • 3 years of case management experience REQUIRED
  • 1 year of leadership experience REQUIRED

Nice To Haves

  • With extensive Medicare/DSNP experience preferred
  • Has knowledge of LTSS Medicaid requirements
  • Has worked with State Medicaid Agency Contract (SMAC)

Responsibilities

  • Managing and coordinating the patient care transitions program.
  • Participating in the system development and implementation of integration of care transitions along the continuum of care.
  • Working in close collaboration with the multidisciplinary team, in all settings to include ambulatory, post - acute providers and health plans.
  • Serving as mentor by role modeling a professional practice consistent with organizational goals, customer service, clinical effectiveness, and standards of care.
  • Developing and managing the departmental budget, compliance to federal, state and regulatory requirements.
  • Managing the DSNP team with oversight of Medicare and Medicaid requirements
  • Overseeing contractual compliance and NCQA requirements
  • Leading 5 direct reports (supervisors) and 66 indirect reports, including care coordinators, ICMs, and LCSWs, etc.

Benefits

  • Medical, Dental, Vision plans
  • Adoption, Fertility and Surrogacy Reimbursement up to $10,000
  • Paid Time Off and Sick Leave
  • Paid Parental & Family Caregiver Leave
  • Emergency Backup Care
  • Long-Term, Short-Term Disability, and Critical Illness plans
  • Life Insurance
  • 401k/403B with Employer Match
  • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
  • Student Debt Pay Down – $10,000
  • Reimbursement for certifications and free access to complete CEUs and professional development
  • Pet Insurance
  • Legal Resources Plan
  • Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

Stand Out From the Crowd

Upload your resume and get instant feedback on how well it matches this job.

Upload and Match Resume

What This Job Offers

Job Type

Full-time

Career Level

Manager

Number of Employees

5,001-10,000 employees

© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service