Manager Care Management Position Available In Brevard, Florida
Tallo's Job Summary: Lead the Health Plans' medical management staff to provide quality case management services, ensuring optimal member experience and adherence to policies and regulations. Manage team accountability, development, and performance. Requires RN license, 5 years of case management experience, 3 years of acute care clinical experience, and strong leadership and analytical skills. Health First is hiring for this role in Rockledge, FL, offering a salary range of $68.5K - $91.6K a year with benefits.
Job Description
Manager Care Management Health First Careers – 3.6
Rockledge, FL Job Details Full-time Estimated:
$68.5K – $91.6K a year 7 hours ago Benefits Health insurance Qualifications Microsoft Powerpoint Microsoft Word Nursing Microsoft Excel Microsoft Outlook Patient monitoring RN License Writing skills Microsoft Office 3 years Analysis skills Bachelor’s degree Case management Acute care Senior level Associate’s degree Associate Degree in Nursing Leadership Full Job Description Job Requirements
POSITION SUMMARY
Lead the Health Plans’ medical management staff who provide quality case management services to Health Plans members. Responsible for establishing, implementing and monitoring the Medical Management department to ensure Health Plans members receive an optimal member experience while adhering to all appropriate policies, regulatory requirements, benefit limitations and resource cost/utilization.
PRIMARY ACCOUNTABILITIES 1.
Promotes associate accountability and competency through leadership and management practice. 2. Leads the Medical Management team to ensure departmental, member satisfaction and financial goals are met. 3. Responsible for and participates in the development of policies, procedures and standards for the department to ensure they meet Medicare, ACHA, FEMQAI, QIO, NCQA and other regulatory agency requirements. 4. Responsible for the oversight and development of programs to meet business objectives, applicable regulations and quality standards. 5. Perform all aspects of human resources including performance management for team, selection assessment, development, feedback, timekeeping, probationary/yearly evaluations, recognition and disciplinary actions. 6. Continuously improve upon staff education, communication/support while maintaining a positive work environment for associates. Work Experience
MINIMUM QUALIFICATIONS
Education:
Associate degree in
Nursing Licensure:
Current RN license to practice in the
State of Florida Work Experience:
o 5 years case management experience o 3 years acute care clinical experience
Knowledge/Skills/Abilities:
o Microsoft Office – Outlook, Word, Excel, PowerPoint o Demonstrated leadership skills o Demonstrated strong interpersonal, business writing and presentation skills o Strong analytical, reporting and problem-solving skills o Ability to read, analyze and interpret professional/legal/medical documents, policy and procedures and government regulations, and legislative documents
PREFERRED QUALIFICATIONS
Education:
Bachelor’s Degree
PHYSICAL REQUIREMENTS
Sedentary – Office Workers Sedentary work involves sitting most of the time Walking and standing or lifting more than 10 pounds are required only occasionally Must be able to tolerate long periods of computer time Benefits
ABOUT HEALTH FIRST
At Health First, diversity and inclusion are essential for our continued growth and evolution. Working together, we strive to build and nurture a culture that recognizes, encourages, and respects the diverse voices of our associates. We know through experience that different ideas, perspectives, and backgrounds create a stronger and more collaborative work environment that delivers better results. As an organization, it fuels our innovation and connects us closer to our associates, customers, and the communities we serve.
