Supervisor, Care Management

Amerihealth Caritas•,

4d•Remote

About The Position

The Supervisor, Integrated Care Management, provides clinical leadership and operational oversight for the Care Management team, ensuring the effective delivery of care coordination, case management, and support services to support organizational goals and regulatory standards.

Requirements

Bachelor’s degree in nursing required.
Current, active, and unrestricted Registered Nurse (RN) license in New Hampshire.
3 to 5 years of case management experience.
2 years of direct supervisory experience.
3 to 5 years of experience within healthcare, managed care, or related environments.
Experience working with regulatory requirements, quality standards, and healthcare compliance programs.
Strong leadership and team development skills with the ability to motivate, coach, and mentor staff.
Knowledge of care management, care coordination, case management, and population health principles.
Ability to interpret and apply healthcare regulations, policies, and clinical standards.
Excellent analytical, problem-solving, and decision-making skills.
Strong organizational and time management skills with the ability to prioritize multiple responsibilities in a fast-paced environment.
High attention to detail and commitment to quality and compliance.
Excellent verbal and written communication skills with the ability to effectively communicate across all levels of the organization.
Strong collaboration and relationship-building skills with internal and external stakeholders.
Proficiency with electronic medical record systems, healthcare technology platforms, and Microsoft Office applications.

Nice To Haves

Experience overseeing clinical operations, care coordination programs, or population health initiatives is highly preferred.

Responsibilities

Provide day-to-day leadership, direction, and oversight of the Care Management team, including staff responsible for case management screening, care coordination, case management, and related support services.
Ensure team members receive appropriate orientation, training, and ongoing development related to organizational policies, departmental procedures, and clinical best practices.
Monitor staff performance, conduct coaching and performance management activities, and support employee engagement and professional development.
Provide clinical oversight and guidance to ensure quality care management services are delivered in accordance with regulatory requirements and organizational standards.
Coordinate and oversee Care Management programs to ensure compliance with state, federal, accreditation, and contractual requirements.
Collaborate with the Manager of Integrated Care Management to prepare reports, analyze operational performance, and identify opportunities for improvement.
Monitor program outcomes, productivity, and quality metrics to ensure effective service delivery and member satisfaction.
Participate in the evaluation, development, and implementation of new or revised workflows, policies, procedures, and care management initiatives.
Support regulatory audits, compliance reviews, and quality improvement activities.
Contribute to the development of educational materials, training programs, and resources designed to support business objectives, member needs, and regulatory requirements.
Partner with internal departments and stakeholders to improve processes, enhance care coordination, and support strategic initiatives.
Promote a culture of collaboration, accountability, and continuous improvement within the Care Management team.