Jacksonville and Fort Lauderdale area, FL

The Manager, Care Coordination, is responsible for the oversight, management and optimization of all care coordination activities as it relates to pre-admission, ambulatory case management, inpatient, social service, home health, health education, behavioral health and other health care delivery programs.Manages staff directly and is responsible for the day-to-day operations of the care management program.

Responsibilities

  • Manage and mentor staff to meet departmental goals; includes Case Managers, Social Workers, and Navigators.
  • Manage schedules and resourcing to ensure proper coverage and staffing ratios to support the Care Coordination practice models
  • Ensure the appropriate administration of member benefits
  • Gather and analyze program data and implement action plans that result in measurable outcomes.
  • Manage and supports the on-going person-centered planning process.
  • Monitors risk assessments for completion by Case Managers within the required timeframe.
  • Confirms that the enrollee’s preferences and goals are honored.
  • Ensures that that Case Managers provides the enrollee with any necessary assistance and accommodations to prepare for and fully participate in the care planning process.
  • Conducts staff meetings, assuring policy and procedures are adhered to and when necessary, modified to address changing strategic objectives.
  • Responsible for orientation of new staff, on-going training, mentoring, and performance reviews.

Requirements

  • Bachelor’s degree (B.A. or B.S., BSN is preferred) from a four-year college or university plus valid/current State of Washington RN license.
  • Case Management training, certification preferred.
  • Minimum of three (3) years clinical experience.
  • Four (4) years of experience in an HMO/IPA/Managed Care setting.
  • Strong leadership skills with experience as a Manager or Supervisor.
  • Innovation, flexibility, and adaptability are key attributes.
  • Knowledge of long-term care, community resources, and cost-effective alternatives regarding patient care delivery systems.
  • Knowledge of, clinical standards of care, NCQA requirements, CMS guidelines, and Medicaid/Medicare contracts and benefit systems is preferred.
  • Knowledge of CPT, ICD-9 and HCPCS codes
  • Basic computer skills in a Windows operating environment including Microsoft Word, Excel, and an e-mail system.
  • Strong interpersonal and decision-making skills

Apply Now

Not sure if you want to apply?
Contact us for more info:
Rebecka Boyd
804-502-0870
nexusexecutivesearch@gmail.com