Manager, Care Management

About the role

Manages a team of clinicians handling care coordination for behavioral health members, aiming for high quality and cost-effective outcomes. Oversees escalations and care management issues involving members or providers.

What you will do

• Direct the daily work of care management staff, reviewing and approving caseloads based on state rules and member needs
• Review required documentation to keep the team compliant with federal and state regulations and contracts
• Create and oversee care management policies and procedures that follow regulatory and industry standards
• Handle escalated and complex cases and guide team members on member concerns
• Resolve complaints and support audits and evaluations of care programs
• Set team goals and report insights to senior care management leadership

What they look for

• A master's degree or graduation from an accredited nursing school
• At least five years of related experience
• An active clinical license in the state, such as LCSW, LMSW, LMFT, LMHC or RN with behavioral health experience
• Leadership background plus strong knowledge of behavioral health, managed care, case management or utilization review
• Excellent communication and presentation skills
• Residence in the state the plan serves

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays and flexible work schedules

Pay

USD 102,900 to 190,500 per year