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Case Management Department Manager

2 months ago


Los Angeles, California, United States Medix™ Full time

Job Overview: Nursing Manager for Case Management

The Nursing Manager for Case Management is tasked with leading the Case Management Department, ensuring adherence to established protocols and guidelines. This role encompasses overseeing case assignments, guaranteeing the prompt execution of Individualized Care Plans (ICPs), and facilitating Interdisciplinary Care Team (ICT) meetings for the Medicare Medi-Medi demographic. Responsibilities also include generating and submitting departmental reports, engaging in audits, recruiting and training new staff, and managing various administrative functions.

Core Responsibilities:

Daily Duties:

  • Supervise daily staff allocations.
  • Authorize completed care plans as a Registered Nurse.
  • Distribute care plans to Case Management Coordinators.

Biweekly Duties:

  • Administer payroll processing.

Monthly Duties:

  • Compile and submit Health Plan Monthly Reports.
  • Participate in Health Plan Monthly Meetings.
  • Conduct team meetings and perform internal audits.

Quarterly Duties:

  • Prepare Health Plan Quarterly Reports.

Annual Duties:

  • Conduct staff performance evaluations.

As Required:

  • Engage in Health Plan Webinars and Audits.
  • Develop and maintain departmental policies and procedures.
  • Contribute to strategic planning initiatives.
  • Provide coverage for ICPs and ICTs during nurse absences.

Qualifications:

  • Active Registered Nurse license in California.
  • At least 5 years of experience in Case Management, with a preference for Managed Care experience.
  • A minimum of 2 years in a managerial role.
  • Experience in managing Medicare member cases is advantageous.

Essential Skills:

  • Consistent attendance and reliability.
  • Strong organizational abilities with meticulous attention to detail.
  • Professional business insight.
  • Flexibility and adaptability.
  • Effective verbal and written communication skills.
  • Robust interpersonal and collaborative skills.
  • Accountability and reliability in task execution.
  • Sound judgment and decision-making capabilities.
  • Dedication to customer satisfaction and exceeding expectations.

Work Schedule: 8:00 AM - 5:00 PM, Monday to Friday