Manager, Care Management Job Description

Manager, Care Management Job Description

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Manager, care management provides guidance to project leads in areas such as project management best practices, facilitation, project planning, quality assurance and quality control best practices, process improvement best practices, etc.

Manager, Care Management Duties & Responsibilities

To write an effective manager, care management job description, begin by listing detailed duties, responsibilities and expectations. We have included manager, care management job description templates that you can modify and use.

Sample responsibilities for this position include:

Performs initial case management assessment to determine care coordination and discharge planning needs
Coordinates the integration of utilization management, care coordination and discharge planning functions for patient care to meet established level of care, length of stay goals and patient needs, complying with all associated regulatory requirements and policies
Anticipates discharge planning needs
Leads multidisciplinary team meetings for review of the patient’s plan of care, utilization management and discharge planning, collaborating with team members to address patient needs and desired outcomes
3 years’ experience in discharge planning in an acute care hospital
Discharge Planning Activities which includes communication with the interdisciplinary team, patient and/or significant other, early coordination with post-acute providers
Effective and timely discharge planning
Effectively functions as part of a self-directed work team
Mobilizes resources to achieve expected goals per the patient’s plan of care and ensures that patient diagnostics are appropriate and necessary and completed with the established timeframe
Assumes final accountability to ensure that care of the patient is appropriately coordinated to meet clinical and transitional needs at time of discharge

Manager, Care Management Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Manager, Care Management

List any licenses or certifications required by the position: CCM, BLS, ACM, CMS, BC, RN, UPMC, CMC, URAC, NCQA

Education for Manager, Care Management

Typically a job would require a certain level of education.

Employers hiring for the manager, care management job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Master's Degree in Nursing, Education, Social Work, Management, Psychology, Sociology, Performance, Gerontology, Health, Leadership

Skills for Manager, Care Management

Desired skills for manager, care management include:

Medicaid
Microsoft Office applications
Discharge planning
Case management
Excel and PowerPoint
Best practices
Health insurance
Medicare and MLTCP
Member satisfaction/incident management and regulations
Quality improvement methodologies

Desired experience for manager, care management includes:

Must have high speed Internet connection and immediate access to computer and phone
Prefer someone who resides in the State of Texas for this role
Communicates timely and effectively with third party payers regarding certification and discharge needs
2 Years minimum of Position-Related Experience in an Acute Medical Hospital setting within the last 3 years OR 2 years minimum of Care Management Experience in an insurance company setting
Bachelor's Degree in Nursing (BSN) or Masters in Social Work (LMSW)
Provides input into the department budget, policies and procedures

Manager, Care Management Examples

1

Manager, Care Management Job Description

Job Description Example
Our company is looking for a manager, care management. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for manager, care management
  • Integrates clinical quality data from present IT systems with payer requirements, collaborating with physicians, office staff, and management on reporting data and performing analytics to improve overall patient care quality
  • Works to assist in report functionality to support care coordinators, and managed care functions
  • Approaches every new patient care coordination effort as an opportunity to assure the culture of “much more than medicine” is achieved, thus engaging patients in care efforts
  • Assures proper billing of all care coordination activities are submitted and received
  • Collaborates with other departments and businesses, as necessary, to meet physician and office staff educational needs
  • Handles full supervisory responsibilities for staff
  • Experience in statistical analysis that can effectively drive program change and priority
  • Organize and integrate cross functional activities, ensuring successful completion of the project, , project on schedule and within budget constraints
  • Own the end-to-end Care cost models for MS hardware products
  • Develop and improve robust analysis and reporting tools and methodologies resulting in greater understanding of costs and product performance
Qualifications for manager, care management
  • Experience leading remote or multi-location teams
  • Invests time in self-development/improvement – Ex
  • Partner with a multi-functional teams to create systematic approach to model and analyze end-to-end Care costs
  • BA/BS in Finance, accounting, economics, math or related degree
  • Five years of related experience in finance or accounting with planning, forecast or analysis
  • Experience in or exposure to manufacturing or supply chain environment a significant plus
2

Manager, Care Management Job Description

Job Description Example
Our growing company is looking to fill the role of manager, care management. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for manager, care management
  • Serves as a resource for FHS staff and leadership in the areas of utilization management, discharge planning and clinical effectiveness strategies
  • Develops and establishes Workforce Management performance goals and assesses performance goals at the direction of the Director
  • Oversees the development and delivery of all management reports related to call centers and ensures accuracy of information to assist in the successful forecasting and scheduling of Customer Service Representatives
  • Develops, analyzes, and monitors ongoing key performance indicators to include service levels, handling times, absenteeism, , measuring daily and intra-daily workforce scheduling effectiveness and performance gaps
  • Analyzes trends and gathers input critical to accurate forecasting
  • BSW with a health care related Master’s Degree (MSW or MHA) or RN with BSN (or related BA/BS)
  • If a nurse, must have current licensure as State of Florida Registered Nurse
  • Ability to communicate effectively with employees so they have a clear understanding of their responsibilities
  • Ability to motivate employees to attain organizational goals
  • In collaboration with iCMP team, monitors the patient’s progress and plan of care with the aid of internal and external utilization and quality guidelines
Qualifications for manager, care management
  • Registered Nurse (R.N.) with active nursing license
  • Existing community and professional contacts within the geographic market and knowledge of community resources
  • Demonstrated expertise in business modeling and financial analysis
  • A seasoned Program Manager (7+ years) with proven track record of managing programs, projects and initiatives in an operations and customer support environment
  • Minimum a Bachelor's degree in a relevant field of study
  • Proven ability to coordinate the activities of cross-functional programs and projects with global teams
3

Manager, Care Management Job Description

Job Description Example
Our growing company is looking to fill the role of manager, care management. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for manager, care management
  • In collaboration with the Director, participates in preparation of department budget
  • In collaboration with the patient/family, physicians and interdisciplinary team, the case manager ensures patient progression through the continuum in an efficient and cost-effective manner
  • Acts as a liaison between providers to optimize communication and facilitates a smooth transition through the healthcare system
  • Coordinates and implements the discharge plan for patients with post-care needs
  • Participates in the development of process/systems to measure/monitor clinical practice
  • Developing and tracking a detailed schedule, using the Agency’s PPMT tool, CA Clarity, and Microsoft Project, showing critical milestones, task dependencies and durations
  • Assigning individual responsibilities within the project team and tracking performance against assigned tasks/deliverables
  • Supporting development of procurement artifacts, including RFIs, RFQs, RFPs, and Contracts in partnership with the HSE Procurement team process workflow
  • Supervising vendor(s), in partnership with the vendor manager and vendor contract owner(s), to ensure timely delivery of quality deliverables according to the contract(s) requirements and project schedule
  • Communicating and coordinating with senior project management, external suppliers/vendors, multiple functional areas and program managers, verbally and via weekly written status reports (following an Agency prescribed template and reporting schedule)
Qualifications for manager, care management
  • Strong personality and experience with management of stakeholders of different levels and departments
  • Leadership flair with the skill to motivate team to perform and exceed expectations
  • Ability to work in a fast paced multicultural environment
  • 3 years plus Project management and leadership experience
  • A Bachelor’s degree in business, science or a related field is required
  • A minimum of 8 years of Project Management experience within an FDA regulated manufacturing environment is required
4

Manager, Care Management Job Description

Job Description Example
Our innovative and growing company is searching for experienced candidates for the position of manager, care management. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for manager, care management
  • Delivering Lessons Learned documentation and presentation at the conclusion of the project and as requested during the life of the project
  • Interact one-on-one and consult with all levels of leadership
  • Provides expertise and project planning, execution, and monitoring
  • Oversees all aspects of assigned projects and maintains a project management framework that enables the core team to successfully execute projects
  • Identify opportunities for scalability and tactics to increase productivity and efficiencies
  • Manages and evaluates the operations/services of the assigned functional area to ensure that all activities are conducted in a timely and cost-effective manner and in accordance with organizational values, professional standards, internal policies/standards/procedures and/or applicable regulatory requirements
  • Lead program design in collaboration with key stakeholders
  • Oversee program delivery in partnership with operational leaders
  • Prepare sales collateral and member materials
  • Conduct sales and account management training
Qualifications for manager, care management
  • Experience with regulatory agency guidelines for medical device manufacturers is highly preferred
  • Over 5 years and up to and including 7 years of experience in the health care industry, which could include healthcare administration or other highly regulated industry
  • Experience in managing vendor compliance and oversight of healthcare related delegation activities, contracting and vendor management
  • Strong cross-functional and project management experience
  • Ability to adapt, demonstration of insight, self-direction and self-discipline
  • Meet deadlines, and deliver expected outcomes with appropriate sense of urgency
5

Manager, Care Management Job Description

Job Description Example
Our company is looking to fill the role of manager, care management. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for manager, care management
  • Plans, organizes and directs the development and implementation of Case Management
  • Develop goals and metrics
  • Critically review reports on process metrics, utilization and cost savings and initiate continuous improvement
  • Quality check and deliver quarterly client reporting
  • Liaison with account management to support client reporting and custom requests
  • Present programs in client meetings as needed
  • Write specifications and document workflows
  • Prepare business cases and write project charters
  • Assist with budget planning and monitoring
  • Demonstrate impact and influence beyond area of responsibility
Qualifications for manager, care management
  • Communicate complex concepts, verbally and in writing
  • Build effective relationships internally and externally, in person and virtually, in order to facilitate professional and business goals
  • Demonstrate awareness attitude, knowledge, and skills to work effectively with a culturally and demographically diverse population)
  • Ability to interpret, evaluate, and clearly document complex medical information using a directive and focused approach in order to identify relevant and actionable conditions, circumstances, and behaviors
  • Demonstrates understanding of products, benefits, healthcare delivery system, accreditation and regulatory requirements, and community resources
  • Knowledge of clinical areas / specific member population

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