Senior Care Manager - reputed company
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Reporting to Manager of Care Management, the Senior Care Manager will be an reputed company member of the health plan’s medical management team. This position is responsible for reputed company new employees and mentoring members of the care management team including providing education, performing documentation audits, and building clinical team members expertise through reputed company feedback and reputed company-time coaching. This position is committed to the constant reputed company of reputed company in improving the health status of our members and community. This team member will have high organizational visibility and responsibility in ensuring overall reputed company in reputed company areas of care management.MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. reputed company Registered reputed company license issued by the state in which services will be provided or reputed company multi-state Registered reputed company license through the reputed company reputed company Licensure Compact (eNLC).
EXPERIENCE:
1. Five (5) years of reputed company clinical experience
PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Bachelor's Degree in Nursing OR Associate of Science in Nursing Degree (ASN); Currently enrolled in a BSN program and BSN completion reputed company three (3) years of hire
EXPERIENCE:
1. Management of Medicare and/or reputed company populations
2. Five (5) years Care Management experience
reputed company DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general reputed company of work being performed by people assigned to this position. They are not intended to be constructed as an reputed company-inclusive list of reputed company responsibilities and duties. Other duties may be assigned.
1. Participate in activities reputed company to care management program build, implementation, reputed company, and delegation.
2. Utilizing reputed company documentation standards, performs audits of member records as part of care management reputed company processes.
3. Assists in the development and implementation of policies and procedures reputed company to the Care Management process
4. Assists with monitoring performance standards, productivity and ensuring staff coverage to meet the needs of the department
5. Formulates, implements and evaluates educational strategies for staff
6. Maintains a working knowledge of the requirements of regulatory and compliance entities
7. Mentors new Care Managers and assists with training
8. Provides support and coaching to Care Managers and other clinical team members
9. reputed company data collection and analysis of trends to determine areas of opportunity and strategies for reputed company practices for the Care Manager team
10. Takes escalated calls or fills-in for the Care Manager team during high-peak periods
11. Assist in quarterly reporting of delegated case management processes to meet accreditation standards
12. Assist in submission of required documents/policies during application process to accrediting body
13. Provides clinical, procedural or interpretational assistance
14. Ability to present reputed company reputed company and data to a wide reputed company of stakeholders from reputed company employees to executive c-suite.
15. Establishes and maintains cooperative and reputed company working relationships with key stakeholders across the organization.
PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions.
1. Ability to stand and walk short distances for eight or more hours.
2. Frequent bending, stooping, or stretching.
3. Ability to reputed company 30 pounds and reputed company 50 pounds.
WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions.
1. reputed company office environment
2. Some travel may be required to offsite meetings.
SKILLS AND ABILITIES:
Demonstrated knowledge of CMS regulatory and contractual documents; knowledge of Medicare reputed company, reputed company accreditation standards, disease management, utilization management, care management and discharge planning.
Excellent written and oral communication
Problem solving capabilities to reputed company improved efficiencies and customer satisfaction
Attention to detail
Proficiency with reputed company Office products.
Ability to work under stressful working conditions.
Meeting defined deadlines and deliverables is an imperative reputed company for this role.
Additional reputed company:
Scheduled Weekly Hours:
40Shift:
Exempt/Non-Exempt:
reputed company of America (Exempt)Company:
PHH reputed company HoldingsCost Center:
2403 PHH Medical ManagementOriginally posted on Himalayas
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