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Senior Manager, Case Management
3 months ago
Position Purpose: Conduct and manage the daily operations of the case management function
- Ensure successful transition of care for members from case management to the utilization management
- Review analyzes of activities, costs, operations and forecast data to determine progress toward stated goals and statistical/financial purposes.
- Develop, implement and maintain compliance with policies and procedures regarding medical case management
- Ensure compliance with federal and state regulations and contractual agreements
- Develop, implement, and maintain case management programs to facilitate the use of appropriate medical resources and decrease health plan financial exposure
Candidate must reside in the state of Arizona.
Education/Experience: Bachelor's degree in nursing or equivalent experience. 4+ years of combined clinical nursing and case management experience. Familiarity with Medicaid managed care practices and policies, CHIP, and SCHIP. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.For Arizona Complete Health - Complete Care Plan:
Education/Experience: Bachelor's degree in nursing or equivalent experience. 4+ years of combined clinical nursing and case management experience. Familiarity with Medicaid managed care practices and policies, CHIP, and SCHIP. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.
Children's team - must have experience working with children who have chronic or complex conditions
License/Certification: RN license, Licensed Clinical Social Worker (LCSW), License Masters Social Worker (LMSW) or Licensed Clinical Professional Counselor (LCPC). Case Management Certification (CCM) preferred.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. p>
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
