Senior Complex Case Management Lead

4 weeks ago


Richmond, California, United States Highmark Health Full time
Job Summary

This role oversees a team of Registered Nurse Complex Case Managers, providing case management services to a specified panel of members with varying health statuses and clinical needs. The successful candidate will be accountable for daily operations, including staffing and scheduling, to ensure effective member outreach within defined timeframes and established processes.

Key Responsibilities:

  • Lead a team of case managers to deliver high-quality services and achieve engagement and clinical targets.
  • Develop and implement policies and programs to improve departmental performance.
  • Collaborate with the Director to focus activities towards a strategic direction and drive performance.
  • Ensure team members are clinically competent and adequately trained in motivational interviewing and other engagement techniques.
  • Review department performance and implement changes to effect continual improvement in services provided.

Requirements:

  • Bachelor's Degree in Nursing.
  • 7 years of experience in the healthcare field, including 3 years of management or supervisory experience.
  • Strong analytical skills, with the ability to interpret and act on productivity, clinical, and financial data.
  • Excellent communication and interpersonal skills, with the ability to work in a matrix management environment.

Preferred Qualifications:

  • Master's Degree in Nursing.
  • Working with diverse populations and understanding the importance of cultural competency.

Language Requirement:

English.

Travel Requirement:

Up to 25%.

Physical, Mental Demands, and Working Conditions:

Office-based, with occasional travel to various work sites.



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