Manager, ECM Transitional Care
Found in: Resume Library US A2 - 1 week ago
What you can expect
Find joy in serving others with IEHP We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience
Under the direction of the ECM Director, the Manager, ECM Transitional Care is responsible for day-to-day management of clinical and non-clinical staff to assure that compliance and adherence to regulatory requirements are completed in a timely and consistent manner using nationally recognized criteria, population health management guidelines, State, and other regulatory guidance. In this capacity, the Manager, ECM Transitional Care will work with hospitals, IPA, ECM Providers, and other departments to ensure coordinated transitional care and continuous cost-effective quality health care for IEHP Members. Will be accountable for the implementation of the ECM benefit that provides timely transition of care, communication of a single point of contact, and authorization of services to address their chronic and social determinants of health as they progress towards their transition. Further, this position interacts with internal and external customers, and Members to facilitate improved care coordination, navigation, referral authorizations services, concurrent review, and discharge planning services.
Additional Benefits:
Perks
IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.
CalPERS retirement
457(b) option with a contribution match
Generous paid time off- vacation, holidays, sick
State of the art fitness center on-site
Medical Insurance with Dental and Vision
Paid life insurance for employees with additional options
Short-term, and long-term disability options
Pet care insurance
Flexible Spending Account – Health Care/Childcare
Wellness programs that promote a healthy work-life balance
Career advancement opportunities and professional development
Competitive salary with annual merit increase
Team bonus opportunities
Qualifications:
Education & Experience
Five (5) or more years of health care experience of which two (2) or more are in supervisory. Experience in care management is required.
Bachelor’s degree from an accredited institution required.
Master’s degree in MPH, MA, MSN, MBA, or other related field from an accredited institution preferred.
Possession of an active, unrestricted, unencumbered Registered Nurse (RN) license issued by the California BRN required.
Key Qualifications
Working knowledge of managed care including nationally recognized criteria, UM processes, care management, CalAim, PHM, DHCS, DMHC, CMS, NCQA regulations.
Aware of the community resources available in Inland Empire.
Excellent writing and communication skills. Strong analytical skills and problem-solving skills.
Demonstrates excellent interpersonal and organizational skills.
Change agent, time management, ability to develop and implement programs using LEAN tools, follow through, strong emotional quotient, demonstrates servant leadership, and prioritize competing priorities.
Start your journey towards a thriving future with IEHP and apply TODAY
Pay Range:
USD $57.02 - USD $75.55 /Hr.
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