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Case Management Product Manager

Genex Services Wayne Full-Time
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Currently seeking a Case Management Product Manager for our Corporate Office in Wayne, PA. MUST have one of the following certifications: CCM, CRC, CDMS, CRRN, or COHN.

The Case Management Product Manager is responsible for product planning and execution throughout the Product Lifecycle, including gathering and prioritizing product and customer requirements, defining the product vision, and working closely with operations, sales, marketing and the product management & development department to ensure goals are met. The job also includes ensuring that the product supports the company’s overall strategy and internal/external customer goals.  Develops products by identifying potential products; conducting market research; generating product requirements; determining specifications, production timetables, pricing models, and time-integrated plans for product introduction; assists in developing marketing strategies.  Responsible for overall product management, development, regulatory compliance, quality management, and support relative to the delivery of Case Management services, including Telephonic & Field Case Management, Vocational Case Management, Utilization Review and IME Services.  Ongoing development and evaluation of case management programs, policies and procedures and training of case management staff. 

Main responsibilities will include but are not limited to:

•         Gain knowledge of customer needs through research and market data.

•         Research and analyze regulatory compliance, including internal and external communications.

•         Assess competition by comparing products.

•         Consult with Sales, Marketing and Operations in the development of case management/managed care products, services, policies & procedures and training/educational materials/programs. 

•         Develop product lines and appraise new ideas for market viability.

•         Maintain professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.

•         Administer Quality Improvement Programs by overseeing review of medical & vocational case management, IME, UR practices and suggesting changes to improve quality of service or compliance with practice standards including industry best practices, customer standards and URAC accreditation standards. 

•         Support Case Management Sales and Operations staff in information requests and technical presentations.

•         Review Clinical Guidelines AGREE II.

•         Develop staff training, including continuing education programs.

•         Other duties as assigned.

Qualifications:

•         B.S., B.A., R.N. or B.S.N. required.  Advanced Degree in a health-related field preferred.

•         Prior experience in Workers’ Compensation as a medical case manager, vocational case manager or Utilization Review Nurse required.   

•         CCM, CDMS, CRC, CRRN or COHN certification required.

•         3 + years Case Management experience required. 

•         Fully versed in quality assurance criteria, regulatory requirements and acceptable standards of case management practice. 

•         Ability to set priorities.  Excellent written and verbal communication skills.  Outstanding project and time management skills.  Highly organized with Strong problem-solving skills.   Customer service and interpersonal skills.  Knowledge of statistical analysis.  Ability to work independently and with a team.  Computer literacy required. 

•         Prior supervisory, product management & development and/or regulatory compliance experience preferred. 

Genex is an equal opportunity, at-will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin.
 

Skills required

Utilization Management
Managed Care
Disease Management
Performance Improvement
Medicare
Case Management
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Job ID: 1234

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GENEX Services, LLC. is one of the nation’s leading providers of disability management and medical cost containment services in the occupational, non-occupational, auto and group healthcare markets. GENEX clients include self-insured employers, insurance carriers, managed care organizations, and third party administrators. Services are provided to over 1200 clients throughout 120 locations in all 50 states, Puerto Rico and Canada. Headquartered in Wayne, PA (15 miles outside of Philadelphia), and with more than 2400 employees and 120 locations throughout the US, Puerto Rico & Canada,

GENEX provides services to self-insured employers, insurance carriers, managed care organizations, and third party administrators. OUR MISSION is to provide exceptional healthcare and disability management solutions to our customers, to be a strategically important business partner, and through our competitive spirit and unsurpassed delivery of innovative services, to create a brighter future for those we serve.

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