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Manager Of Care Management (44862)

    Highlights

    Identifies opportunities and cost/benefit for new CM programs and enhancements to existing programs, using data analysis tool. This position assists in developing and operationalizing new programs and ensures regulatory and contractual requirements are met.

    Numbers & Facts

    LocationSmithfield, RI
    IndustryHealthcare Services
    Company Size100 to 499 employees
    Websitehttps://www.nhpri.org/

    Description

    This position oversees operational activities of the Care Management area of the Medical Management department. This includes program development and monitoring, staff development including overseeing frontline supervisors. This position assists in developing and operationalizing new programs and ensures regulatory and contractual requirements are met.

    Duties and Responsibilities

    Responsibilities include, but are not limited to the following:

    • Develops, executes and evaluates work plan for area of responsibility
    • Ensures ongoing monitoring, evaluation, and outcome measurement for all Case Management (CM) programs
    • Provides regular reports and presentations on clinical outcomes of CM programs
    • Identifies opportunities and cost/benefit for new CM programs and enhancements to existing programs, using data analysis tool
    • Assists with developing case management programs for new lines of business
    • Provides supervision, direction and guidance to team while serving as the subject matter expert and lead on functional deliverables
    • Provides performance feedback and coaching to staff, as well as makes hiring and termination decisions
    • Assist in the training of new staff and providing an environment of continuous learning for existing staff
    • Sets performance standards and productivity measures for direct reports
    • Professional development of staff, including identification of educational opportunities, annual performance appraisals and goal development
    • Determines/monitors staffing ratios
    • Develops and ensures consistency in CM documentation standards
    • Works with Clinical Trainers in the development of comprehensive role specific orientation/training programs
    • Manages the development of CM policies and procedures and ensures annual review and revision
    • Collaborate with Chief Medical Officer and Medical Director on new and existing clinical programs
    • Serves as organizational consultant for CM performance practice
    • Participates in administrative budget development and monitoring for area of responsibility
    • Identifies and recommends opportunities for improvement and implements process improvement activities
    • Representative of CM programs with state and community partners
    • Collaborate with Matrix partners to develop, maintain and evaluate programs
    • Other duties as assigned

    About Company

    Neighborhood's employees come from a diverse background but all are committed to creating a more equitable health care system. Our array of experiences allows us to have a broad perspective and great creativity in facing whatever challenges arise. Unlike many other health insurance companies, we have nearly 30 nurses and social workers on staff. This structure speaks to our focus on active and compassionate care management for our members; we know that people who are alienated from the health care system require additional advocacy, outreach and support.

    Neighborhood offers an exceptional compensation package to employees. We annually review base salaries/benefits and adjust as appropriate.

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