Care Management Manager

24 hours ago


Woodland Hills, California, United States Elevance Health Full time
Job Summary:

The Mgr I Care Mgmt is responsible for leading a team of clinicians in promoting quality member outcomes, optimizing member benefits, and promoting effective use of resources. Key responsibilities include:

Key Responsibilities:

  • Assessing the medical necessity of inpatient admissions, outpatient services, out-of-network services, and appropriateness of treatment setting and level of care.
  • Overseeing process improvement, quality assurance, and adherence to applicable medical policy, care management best practices, relevant clinical standards, and member contract.
  • Ensuring prevention and health management program accreditation standards are achieved.
  • Participating in establishing strategic plans and objectives; aligning, developing, and implementing functional area policies and procedures to support strategic plans and objectives.
  • Participating in establishing and managing the annual budget productivity targets.
  • Hiring, training, coaching, counseling, and evaluating the performance of direct reports.

Requirements:

  • BS in Nursing and a minimum of 5 years of acute care clinical experience; or any combination of education and experience, which would provide an equivalent background.
  • Current unrestricted CA RN license in applicable state(s) required.
  • Certification as a Case Manager preferred.
  • Additional schooling or certifications preferred.

What We Offer:

Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution, among other benefits. The salary range for this position is $102,765.00 - $127,765.00, based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
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