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Mgr I HCMS-(2)-88233

Mgr I HCMS-(2)-88233

Job Description

Must be located in Nashville, TN but can work from home 50%.  Responsible for providing clinical supervision to a team responsible for coordinating member service, utilization, access, and concurrent review to ensure cost effective utilization of health, mental health, and substance abuse services. Primary duties may include, but are not limited to: Manages and oversees team responsible in case finding and coordinating cases that involve comorbid conditions. Coordinates service delivery to include member assessment of physical and psychological factors. Partners with providers to establish short and long term goals that meet the member's needs, functional abilities, and referral sources requirements. Identifies members with potential for high risk complications. Reviews benefit systems and cost benefit analysis. Evaluates medical, mental health and substance abuse service for cost containment. Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Job Requirements

Requires a BA/BS; 5 years of experience in Health Care Management; or any combination of education and experience, which would provide an equivalent background. Current unrestricted RN PA, LSW, LPC, or LMHC license in applicable state(s) required. MSN, MPH, MPA, MSW or MBA with Health Care Concentration preferred. Certified Case Manager Certification preferred.  1 or more years supervisory or lead experience is preferred.  Healthcare experience is required, managed care is preferred. UM experience required.  Must be proficient with Word and Excel.  Knowledge of TENNCare and Medicaid experience are preferred.


Job Snapshot

Employment Type Full-Time
Job Type Nurse, Health Care
Education Not Specified
Experience Not Specified
Manages Others No
Industry Managed Care
Required Travel None
Job ID 88233
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Mgr I HCMS-(2)-88233

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