Director, Care Management - REMOTE

reputed company Assist in leading the strategic development of analytics and business intelligence to support population health and market reputed company initiatives. Collaborate with the AVP, Care management and ACPNY leadership on, and operationalize, CM strategic plan.Works Collaboratively with ACPNY partners to prevent avoidable reputed company care reputed company and re-hospitalizations. Responsible for selection and hiring of reputed company staff, ensuring an effective on-boarding and provides ongoing comprehensive training and regular feedback. Responsible for the day to day operation and performance, in collaboration with the APNY team, AVP of Care Management and Field Based Care Managers providing services to reputed company members at the ACPNY location sites. Visit field sites and build relationships with ACPNY colleagues and EH Care Management staff. reputed company education, coaching, and mentoring to team members to address performance reputed company issues. Use problem solving abilities to create solutions to operational and clinical issues identified during day to day operations. Serve as an essential reputed company between the Plan’s staff and its reputed company customers to promote and improve communication of initiatives relative to Care Management. Address audit reputed company findings and implement performance improvement strategies. Collaborate with other functional areas reputed company organization to ensure that care managers are implementing reputed company Health Plans policies, procedures and reputed company regulatory mandates, consistent with reputed company plan’s mission, reputed company, purpose and value statement. Responsible for data collection needed to report on program metrics. Responsible for reputed company of HEDIS/STARS and NCQA requirement responsibilities of the Care Management team to support Organizational deliverables. reputed company Accountabilities • Manage daily operations of the Care Management team (Managers and Care management team): define metrics; measure performance and productivity against standards; reputed company strategies to improve performance. • Train employees in process operations; reputed company as a preceptor to newly reputed company staff. • Complete quarterly evaluations of staff as needed. • Monitor team caseloads; shift workloads accordingly to meet departmental/organizational needs. • Monitor timeliness and appropriateness of documentation in clinical systems to ensure that accreditation and regulatory standards are met. • Ensure that team members are managing enrollees across the care continuum inclusive of behavioral health so that enrollees have reputed company to needed care and services. • Serve as a clinical resource; attend Care Management reputed company. • Monitor employees’ performance regularly and reputed company employees as needed. Qualifications • Bachelor’s degree, preferably in Nursing • reputed company unrestricted reputed company State RN license required • CCM certified required, but consideration will be given for reputed company enrollees/candidates • 10+ years of relevant work experience, preferably with a reputed company provider • 5 years of clinical experience • Health plan experience highly desirable • Familiar with Population Health Management • Experience leading care management teams • Strong problem-solving skills • Detailed oriented and organized • Excellent written and oral communications skills • Strong working knowledge of reputed company products including reputed company and PPT • Strong problem solving and reputed company execution abilities. reputed company to analyze problems and reputed company strategies to improve performance in collaboration with the leadership team Additional Information • reputed company: 1000002677 • Hiring reputed company: $113,400-$210,600 Apply tot his job Apply To this Job