Clinical Care Services Manager

2 weeks ago


Albuquerque, New Mexico, United States VetJobs Full time
Job Summary

We are seeking a highly skilled Clinical Care Services Manager to join our team at VetJobs. As a key member of our organization, you will be responsible for managing, supervising, and coordinating clinical and non-clinical management staff, including utilization management and intensive care management staff.

Key Responsibilities
  • Assist clinical management in the development and ongoing management of designated staff.
  • Perform care management review activities consistent with Magellan policies, procedures, and standards.
  • Conduct recruitment, interviewing, and selection of properly qualified staff members and ensure appropriate orientation is provided.
  • Regularly monitor the performance of care management staff and monitor adherence to efficiency goals for all staff, including case volume, case closure rates, average handle time, and other metrics.
  • Supervise care management staff through approved audit processes, including performing annual reviews, and provide counseling and disciplinary action as necessary.
  • Coordinate quality improvement activities under the direction of clinical management.
  • Assist management in the development of strategic and operational goals and plans.
  • Assist management in the identification and coordination of necessary clinical and client service training needs.
  • Analyze specific utilization problems, plan, and implement solutions that directly influence quality of care and cost efficiency.
  • Supervise the collection of pertinent clinical information while maintaining a good rapport and relationship with providers.
Requirements
  • 5 years post-degree experience in a direct care clinical setting; managed care experience preferred.
  • One or more of the following current, active licenses are required: BCBA, LCSW, LMFT, LMSW, LPCC, LPC, PC, or RN.
  • If RN, BSN preferred but ASN considered with additional experience.
  • Thorough knowledge of physical, medical specialty, and/or mental health community resources and providers.
  • Thorough knowledge of healthcare services in physical health, behavioral health, or other medical specialty area based on pod management.
  • Considerable skill in interpreting clinical treatment information and making appropriate referral and triage decisions.
  • Must meet Magellan's credentialing criteria for RN, Masters, or Doctoral level provider.
Additional Information

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary, and other benefits and perks that enhance your physical, mental, emotional, and financial wellbeing.

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.



  • Albuquerque, New Mexico, United States National Guard Employment Network Full time

    Job SummaryWe are seeking a highly skilled Clinical Care Services Manager to join our team at National Guard Employment Network. As a key member of our organization, you will be responsible for managing, supervising, and coordinating clinical and non-clinical management staff, including utilization management and intensive care management staff.Key...


  • Albuquerque, New Mexico, United States Ardent Health Services Full time

    OverviewWe are seeking a skilled Clinical Care Manager RN to join our team at Lovelace Medical Center in Albuquerque, NM. As a member of our acute care hospital, you will play a vital role in providing comprehensive care to our patients.About the RoleThe Clinical Case Manager RN will assess the social, psychosocial, cultural, environmental, and financial...


  • Albuquerque, New Mexico, United States Health Care Service Corporation Full time

    Job SummaryThis position is responsible for supervising clinical staff involved in various clinical operations, including risk management and clinical appeals. The successful candidate will be responsible for hiring, training, performance reviews, pay administration, change management, and ensuring staff meet/exceeds goals and initiatives. The ideal...


  • Albuquerque, New Mexico, United States Health Care Service Corporation Full time

    Job SummaryThis position is responsible for supervising clinical staff involved in various clinical operations, including risk management and clinical appeals. The ideal candidate will have experience in hiring, training, and performance reviews, as well as pay administration and change management.The successful candidate will be responsible for ensuring...


  • Albuquerque, New Mexico, United States Comagine Health Full time

    Job SummaryWe are seeking a highly skilled Clinical Care Manager to join our team at Comagine Health. As a Clinical Care Manager, you will be responsible for providing operational management of clinical staff who provide utilization review and specialty reviews.Key Responsibilities:Develop, implement, and maintain departmental policies and procedures,...

  • RN Care Manager

    6 days ago


    Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time

    About the Role:We are seeking a skilled RN Care Manager to join our team at Presbyterian Healthcare Services. As a RN Care Manager, you will play a critical role in facilitating collaborative care between patients, families, physicians, and other healthcare professionals.Key Responsibilities:Proactively manage patient care along a continuum, ensuring...


  • Albuquerque, New Mexico, United States Ardent Services Full time

    Job SummaryAt Ardent Services, we are seeking a skilled Clinical Case Manager to join our team. As a Clinical Case Manager, you will play a vital role in assessing the social, psychosocial, cultural, environmental, and financial situations concerning our patients and their families. Your primary responsibility will be to advocate for the rights and dignity...


  • Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time

    Job SummaryWe are seeking a skilled Utilization Management Nurse Specialist to join our team at Presbyterian Healthcare Services. As a key member of our healthcare team, you will play a vital role in ensuring that our patients receive the highest quality care while minimizing unnecessary costs.Key Responsibilities• Perform clinical reviews to ensure that...

  • RN Care Manager

    2 weeks ago


    Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time

    About the RoleWe are seeking a skilled RN Care Manager to join our team at Presbyterian Las Estancias Medicine Clinic. As a key member of our primary care team, you will play a vital role in facilitating collaborative care between patients, families, physicians, and other healthcare professionals.ResponsibilitiesProactively manage patient care along a...


  • Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time

    Job Summary:We are seeking a skilled Clinical Care Specialist to join our team at Presbyterian Healthcare Services. As a Clinical Care Specialist, you will provide high-quality patient care in the outpatient setting, working closely with our team of healthcare professionals to deliver exceptional patient outcomes.Responsibilities:* Provide direct patient...

  • Clinical Director

    3 weeks ago


    Albuquerque, New Mexico, United States Maxim Healthcare Services Full time

    Maxim Healthcare Services Clinical Manager Job DescriptionWe are seeking a highly skilled Clinical Manager to oversee the management of our clinical operations. The ideal candidate will have a strong background in nursing and experience in supervising clinical teams.Key Responsibilities:Manage and direct clinical supervisors to ensure high-quality patient...

  • RN Care Manager

    2 weeks ago


    Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time

    Job SummaryWe are seeking a skilled RN Care Manager to join our team at Presbyterian Healthcare Services. As a key member of our Family Medicine Clinic, you will play a vital role in coordinating patient care and ensuring seamless transitions between healthcare services.Key ResponsibilitiesProactively manage patient care across the continuum, facilitating...


  • Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time

    Job Summary:As a Clinical Care Assistant with Presbyterian Healthcare Services, you will play a vital role in providing high-quality patient care in the outpatient setting. You will work under the direction of licensed clinicians to perform specific patient care procedures and tasks, ensuring the best possible outcomes for our patients.Responsibilities...


  • Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time

    Job Summary:We are seeking a skilled Clinical Liaison to facilitate Hospice and Palliative Care referrals from all sources. The ideal candidate will obtain reviews and coordinate necessary information to complete the clinical assessment of the patient for the correct program and location within that program.Responsibilities: Facilitate Hospice and Palliative...

  • Nurse Manager

    2 weeks ago


    Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time

    Job Title: Nurse Manager - Surgical ServicesPresbyterian Hospital is seeking an experienced Nurse Manager to join the Surgical Services Unit.About the Role:The Operating Room Nurse Manager will be responsible for the staff and resources of 16 Operating Rooms and will assist with the development and monitoring of the quality and standards pertaining to the...


  • Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time

    Job Summary:As a Case Manager RN at Presbyterian Healthcare Services, you will play a vital role in delivering effective and efficient patient care. Your clinically-based case management skills will integrate utilization management, care coordination, and transition planning functions to ensure seamless patient experiences. With a designated caseload, you...


  • Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time

    Job Summary:The Case Manager I provides clinically-based case management to support the delivery of effective and efficient patient care. This role integrates utilization management, care coordination, and transition planning functions. The Case Manager I has overall accountability for a designated case load and plans effectively to meet patients' needs,...


  • Albuquerque, New Mexico, United States Thrive Skilled Pediatric Care Full time

    About the RoleWe are seeking a highly skilled and dedicated Client Relationship Manager to join our team at Thrive Skilled Pediatric Care. As a key member of our staff, you will be responsible for cultivating and managing relationships with the parents of our clients and the nurses who care for them.This is a fantastic opportunity to build and grow your own...


  • Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time

    Care Coordination RN - Case Manager Job SummaryThe Presbyterian Healthcare Services is seeking a skilled RN - Case Manager to join our team. As a RN - Case Manager, you will be responsible for providing clinically-based case management to support the delivery of effective and efficient patient care.Key Responsibilities:Integrate utilization management, care...


  • Albuquerque, New Mexico, United States Presbyterian Healthcare Services Full time

    Job SummaryThe Case Manager I provides clinically-based case management to support the delivery of effective and efficient patient care. This role integrates utilization management, care coordination, and transition planning functions to ensure seamless patient care.Key ResponsibilitiesProvides clinically-based case management to support patient...