Manager, Case Management Nurse Management

Your Role

The Care Management team is looking for a leader with who can lead and oversee our team to ensure the effective coordination of patient care across multiple settings. The Manager of Care Management will report to the Senior Manager of Care Management. In this role you will be responsible for managing care management programs, optimizing patient outcomes, improving care delivery processes, and ensuring compliance with regulatory requirements. The Manager will supervise a team of care managers while collaborating with healthcare providers, payers, and members to achieve optimal clinical outcomes. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Requires a current and valid CA RN License or valid RN license(s) from other state(s). Preferred licensure from a compact state. If assigned to another state, must maintain an active, unrestricted RN license in assigned state(s) or the ability to obtain required RN license (in addition to primary state license) within 90 days of hire
• Bachelor of Science in Nursing or advanced degree preferred
• Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements
• Requires 7 years of prior relevant experience
• Requires 3 years of management experience gained as a team leader, supervisor, or project/program manager
• Requires 3 years of experience in inpatient, outpatient, or managed care environment
• Excellent communication, interpersonal, and negotiation skills
• Knowledge of NCQA requirements preferred
• Ability to analyze data and create reports to guide decision-making and process improvements