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RN Manager II or I - Health Care Management Services (UM) (80041)
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RN Manager II or I - Health Care Management Services (UM) (80041)

Job Description

WellPoint is one of the nation's leading health benefits companies and a Fortune Top 50 company. At WellPoint, we are working together to transform health care with trusted and caring solutions.
 
Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people’s lives, and to take your career further than you can imagine. 
 
RN Manager II / I- Health Care Management Services (UM)- Pine Street/Manhattan:

  • Responsible for leading the development, implementation, and coordination of a comprehensive health care program that will assist Health Care Management Services, Medical Management, and/or Utilization management, resulting in improved health outcomes for members.
  • Primary duties may include, but are not limited to: Assists in the development and implementation of clinical programs. Ensures continued compliance with specific medical management standards.
  • Assists in the development of medical and clinical management policy, procedures, and strategies.
  • Evaluates medical, mental health, and substance abuse services for cost containment.
  • Ensures program deliverables by monitoring established goals and implementing improvement strategies accordingly. Supports quality initiatives and activities including clinical indicators reporting, focus studies and HEDIS reporting.
  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Job Requirements

Current unrestricted RN license in applicable state(s) required. Masters in related Health/Nursing field preferred. Certified Case Manager Certification preferred. Previous management/leadership experience preferred.

WellPoint is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2013 DiversityInc magazine Top 50 Company for Diversity.  To learn more about our company please visit us at www.wellpoint/com/careers.  EOE.M/F/Disability/Veteran.

Job Snapshot

Employment Type Full-Time
Job Type Nurse
Education Not Specified
Experience Not Specified
Manages Others Yes
Industry Managed Care
Required Travel None
Job ID 80041
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RN Manager II or I - Health Care Management Services (UM) (80041)


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