Manager Care Management

4 weeks ago

Grand Rapids, United States Metro Health Full time

Metro Health (now the University of Michigan Health-West) is looking for Manager Care Management - Clinically Integrated Network * Days - 40hrs/wk The Manager of Care Management is responsible for the leadership of the Care Management Team. This is pivotal leadership role is responsible for overseeing and optimizing the delivery of care management services within the healthcare organization. It involves leading a team of care managers, clinical coordinators, and support staff to ensure effective patient care coordination and comprehensive support and oversight of care coordination, care management, and transition/discharge planning across the care continuum. The Manager of Care Management works in collaboration with leadership and other members of the interdisciplinary care team to meet individual-specific and age-related individual needs linking cost resource management and quality to individual care acting as the change management lead supporting Value-Based Care (VBC). The Manager of Care Management will ensure tasks and projects are consistent with organizational strategies, commitments, target goals, and timelines. This role will act as the frontline Care Management subject matter expert for primary care practices for ongoing support, oversight, and training; but will also be a conduit to the CIN and Medical Group Leadership to convey expanded needs, operational concerns, strategic opportunities, and future planning ideas. They will be relied upon for their valuable clinical insight and will serve as the operational care management lead. Requirements: Bachelor's degree in Nursing or BS in a health-related field or higher education required. A master's degree in healthcare management, Nursing, or a related field preferred. Registered Nurse with current license to practice nursing in the State of Michigan. Minimum 5 years of case management experience in an acute or post-acute provider or health plan. Five (5) years of experience in staff management and leadership preferred. Working knowledge and ability to apply professional standards of practice in a work environment. Working knowledge of computers and basic software applications used in job functions such as word processing, databases, spreadsheets, etc. Proven experience in care management, including previous leadership or managerial roles. Knowledge of relevant healthcare regulations and accreditation standards, such as those set forth by NCQA (National Committee for Quality Assurance) and/or CMS (Centers for Medicare & Medicaid Services), to ensure the ambulatory care management program meets all necessary requirements Excellent communication, interpersonal, and problem-solving skills. Ability to analyze data and use insights for strategic decision-making. Demonstrated ability to lead and motivate a diverse team of care management professionals. Commitment to patient-centered care and continuous improvement. Current unrestricted professional license in Michigan required. Certification in Case Management or equivalent certification from equivalent certifying body and/or healthcare leadership recognition preferred. Experience with managed care data systems and reporting. Proficiency in utilizing and managing care management software systems, electronic health records (EHRs), and other relevant health information technology platforms. This includes understanding how to extract and analyze data from these systems to inform decision-making and track performance metrics. Knowledge of patient assessment tools and methodologies to identify patients' healthcare needs, develop personalized care plans, and monitor progress over time. This includes understanding risk stratification and prioritizing patient interventions. Familiarity with utilization management principles, including m

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