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D-snp Care Management Program Manager
3 months ago
**Salary Range**: $114,138 - $171,207
**Job Summary**
The Duals Special Needs Program (D-SNP) Care Management Program Manager reports to the Health Services Officer (HSO) and is pivotal in developing, launching, and managing CenCal Health’s D-SNP Care Management program. This role ensures strict adherence to CMS D-SNP regulations and spearheads ongoing enhancements to the Care Management Program. The D-SNP Care Management Program Manager is a seasoned expert in D-SNP program management, driving continuous improvements in healthcare delivery.
**Duties and Responsibilities**
- Collaborates with the Health Services Officer (HSO) and cross-functional teams to develop and implement the Medicare Care Management program, ensuring alignment with organizational goals and objectives.
- Leads the development of Medicare Care Management (MCM) policies, procedures, and workflows to support effective care management, risk stratification, and member engagement.
- Provides guidance and support to care management teams in the implementation of MCM requirements, including annual assessments, care plan interventions and interdisciplinary care teams.
- Collaborates with IT/Reporting to develop regulatory and operational reporting.
- Oversees the collection, analysis, and reporting of MCM-related data and performance metrics and provide regular updates to senior leadership.
- Collaborates with Quality Improvement and Population Health teams to support initiatives.
- Serves as the primary point of contact for internal and external stakeholders regarding MCM-related inquiries, audits, and compliance issues.
- Stays informed about changes in CMS regulations, guidance, and best practices related to MCM, and ensure timely implementation of required updates.
- Leads training and education initiatives to increase awareness and understanding of D-SNP requirements among care management teams and other stakeholders.
- Drives continuous operational improvement in processes and outcomes through data-driven analysis, benchmarking, and best practice sharing.
**Knowledge/Skills/Abilities**
- In-depth knowledge of Medicare regulations, including MCM requirements, and experience with CMS audits and compliance activities.
- Strong project management skills, with the ability to lead cross-functional teams and drive initiatives to completion.
- Excellent communication and interpersonal skills, with the ability to collaborate effectively with stakeholders at all levels of the organization.
- Analytical mindset with the ability to interpret data, identify trends, and make data-driven decisions.
- Commitment to quality, patient-centered care, and continuous improvement.
**Education and Experience**
- Bachelor’s degree in nursing, Healthcare Administration, Public Health, or a related field or an equivalent combination of education and experience.
- Minimum of 5 years of experience in healthcare, with a focus on D-SNP and care management.
- Certification in Case Management (CCM), Certified Professional in Healthcare Quality (CPHQ), or similar credentials preferred.
- Experience working with non-profit organizations, such as COH’s health plans.
- Experience with Policy and workflow development and implementation.
