Supervisor, Care Management

GLOBALHEALTH HOLDINGS LLC•Oklahoma City, OK

3d•Remote

About The Position

Under the direction of the Director, Health Services, the Supervisor, Care Management develops and leads assigned members of the Care Management Team. The role is responsible for determining, planning, developing, organizing, implementing, and evaluating care management for SNP and other high-risk, high-utilization members. The position supervises Care Management Team members and serves as a resource to all lines of business. The work environment is currently remote, subject to some state exclusions. The employee must have access to a reliable, secured internet connection and maintain the confidentiality and security of business information, including Protected Health Information (PHI), in accordance with HIPAA and company policies. Occasional travel may be required. Duties and responsibilities may change.

Requirements

Active Registered Nurse license in the state of Oklahoma.
Knowledge of current nursing processes, techniques, and established standards, including disease management, medications, and community resources.
Strong attention to detail, organization, and time-management skills, including the ability to multitask, learn new skills, and reach set goals.
Strong organizational, leadership, problem-solving, and decision-making skills.
Ability to communicate clearly and effectively, both orally and in writing.
Knowledge of Microsoft Word, Excel, and PowerPoint.
Proven ability to work independently or as a member of a team.
Ability to maintain the confidentiality and security of business information, including PHI.

Nice To Haves

Active multi-state RN license.
Previous experience in managed care or utilization management.

Responsibilities

Select, orient, and develop appropriately qualified staff for the Care Management Department.
Maintain and monitor departmental processes to support timely outreach and management of identified members.
Evaluate reports to identify outcomes and program effectiveness.
Analyze outcomes and use data to develop processes that improve program effectiveness.
Identify training needs and facilitate appropriate education and training.
Communicate regularly with employees, including through staff meetings, to share information relevant to their job functions.
Serve as a resource to all lines of business.
Communicate with the Director, Health Services about departmental issues, team-member performance improvement opportunities, member issues, program status, and compliance issues.
Maintain the confidentiality of business information, including PHI, as required by HIPAA and company policy.
Use reasonable and necessary safeguards to protect company records from unauthorized access, disclosure, or damage and follow privacy and security policies.
Supervise members of the Care Management Team.