Consumer Directed Services Manager

3 weeks ago


Hyattsville, United States Kaiser Permanente Full time
Job Summary:
The Manager of Outpatient Continuing Care is responsible for supervising and managing teams of personnel who support case management of various member populations in the outpatient or community setting.  These populations include, but are not limited to special needs populations, members with complex needs and members with general case management needs.  This position ensures compliance with NCQA, state, federal and other regulatory accreditation standards. The Manager of Outpatient Continuing Care responsible for consumer-directed services ensures oversight and is the chief liaison with the Fiscal/Employer Agent.  This position focuses on all areas of consumer-directed services including patient pay payment issues, fraud allegations, and reporting suspected fraud, waste, and abuse.

Essential Responsibilities:
  • Manages and directs case managers and support staff to ensure case management activities are applied in a consistent and effective manner.
  • Oversees day to day activities of assigned staff, to include staff scheduling, caseload assignment and appropriate utilization of resources.
  • Conducts case level reviews and provides feedback to staff on a regular basis.
  • Ensures member benefits are interpreted and applied correctly and in compliance with state and federal regulations.
  • Partners with other members of the UMOC and Continuing Care teams to develop and implement collaborative processes.
  • Supports professional growth by providing education, training and appropriate resources.  
  • Conducts performance evaluations, provides coaching and acts as a mentor to direct reports.
  • Performs other related duties as assigned.


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