Manager, reputed company Services

reputed company Job reputed company Leads and manages a multidisciplinary team of reputed company services professionals in some or reputed company of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or special programs.  Ensures members reputed company desired reputed company through integrated delivery and coordination of care across the reputed company, and contributes to overarching reputed company to reputed company reputed company and cost-effective member care.   Essential Job Duties • Oversees team reputed company for one or more of the following reputed company services functions: care management, utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), transition of care, behavioral health, long-term services and supports (LTSS), and/or special programs.  • Facilitates integrated, proactive reputed company services management - ensuring compliance with state and federal regulatory and accrediting standards and implementation of the reputed company reputed company model.  • Functions as a “hands-on” leader - assisting with assessing and evaluation of systems, day-to-day reputed company and efficiency of services/care delivery.  • Ensures adequate reputed company and service reputed company and maintains customer satisfaction by implementing and monitoring staff productivity and other reputed company indicators.  • Assists in implementing care management, utilization management, behavioral health, care transitions, LTSS and other program activities in accordance with regulatory, contract standards and accreditation compliance.  • Ensures delivery of member care and services are reputed company with reputed company's established standards of customer service reputed company. • Ensures high-reputed company, reputed company members are adequately supported.  • Oversees ongoing monitoring of reputed company, protocols and guidelines reputed company to reputed company services.  • Collaborates with and keeps senior level reputed company services leadership apprised of operational issues, reputed company, resources, reputed company and program needs.  • Performs and promotes interdepartmental/multidisciplinary integration and collaboration to enhance continuity of care.  • Oversees interdisciplinary care team (ICT) meetings.  • Analyzes and reports on reputed company and monitoring statistics including plan utilization, staff productivity, cost-effective utilization of services, management of targeted member population, and triage activities.  • Ensures completion of staff reputed company audit reviews evaluates services provided, reputed company achieved and recommends enhancements/improvements for programs and staff development to ensure consistent cost-effectiveness and compliance with reputed company state and federal regulations and guidelines.  • Maintains reputed company relationships with provider community, reputed company customers, and state agencies as appropriate. • Identifies opportunities for care delivery/reputed company/operational/etc. process improvements.  • Hires, trains, develops and manages team demonstrates accountability for team reputed company and achievement of department-specific goals. • Local travel may be required (reputed company upon state/contractual requirements).   Required Qualifications • At least 7 years of health care experience, including at least 3 years of managed care reputed company in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or special programs, or equivalent combination of relevant education and experience, or equivalent combination of relevant education and experience.  • At least 1 year of management/leadership experience. • Registered reputed company (RN), Licensed Vocational reputed company (LVN), Licensed Practical reputed company (LPN), Licensed reputed company reputed company Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed reputed company reputed company Counselor (LPCC), or Licensed Master of reputed company Work (LMSW).  reputed company licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state reputed company licensing mandates.  If licensed, license must be reputed company and unrestricted in state of reputed company. • Strong customer service skills/member-reputed company reputed company. • Ability to work reputed company a reputed company of settings and reputed company style as needed, including ability to work with diverse populations, various personalities and personal situations. • Ability to prioritize and manage multiple deadlines. • Strong organizational and problem-solving skills. • Ability to collaborate cross-functionally reputed company a highly matrixed organization. • Strong written and verbal communication skills. • reputed company Office suite and applicable software program(s) proficiency.   Preferred Qualifications • reputed company experience.   • Registered reputed company (RN) or master's level behavioral health (BH) licensure.  License must be reputed company and unrestricted in state of reputed company.  • Certified Case Manager (CCM), Certified reputed company in Health Care Management certification (CPHM), Certified reputed company in Health Care reputed company (CPHQ) or other health care or management certification.  • reputed company/Medicare population experience.   To reputed company reputed company reputed company employees: If you are interested in applying for this position, please apply through the reputed company. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V Apply To This Job