Manager, Integrated Care Management

Role Overview:

Under the supervision of the Director Clinical Market Population Health, the Manager of Integrated Care Management is responsible for the daily operations of the Complex Care Management and Behavioral Health teams. Responsible for compliance with State and Federal laws and business plan goals.

Work Arrangement:

• Must reside in South Carolina.
• Ability to travel to based on business needs.

Responsibilities:

• Plans, organizes and directs the development and implementation of Case Management operations.; Ensures staff is properly trained, oriented and provided with regular professional development.; Identifies opportunities for improvement, both clinical and administrative, and assists the Director in the strategic planning processes for these functions.;
• Coordinates and implements the development of recommended policies and programs.; Coordinates, establishes and monitors achievement of departmental goals and objectives.; Responsible for achievement of assigned NCQA standard compliance and compliance with all applicable State and Federal laws, as well as achievement of assigned incented health outcomes.;
• Directs effectiveness of existing programs and services, identifies and evaluates new programs and services to address cost effectiveness, proposed process improvements and to achieve compliance with NCQA, CMS and State incented health outcomes.
• Participates in and supports the corporate Population Health Strategy.;
• Directs the case management activities to be in compliance with the state Department of Health and Human Services (DHHS) requirements for case management.;
• Works across departmental lines to achieve objectives.
• Creates and supports an environment that fosters teamwork, cooperation, and respect.; Establishes and maintains positive communication and professional demeanor with employees, providers and acts as liaison with outside entities as required.; Demonstrates and supports commitment to corporate goals and mission.
• Performs other related duties and projects as assigned.

Education/ Experience:

• Bachelor’s degree in nursing or other health related field required.;
• 3+ years professional clinical practice experience in medical and behavioral health.
• 1+ years of case management experience in a clinical managed care environment required, preferably within a Medicaid business unit.
• 3+ years;progressive leadership experience to include 1 year of experience within a managed care organization.
• Experience managing a large team of 40 remote licensed and unlicensed associates.
• Experience leading projects with internal and external stakeholders.
• Strong change management experience.

Licensure

• Valid Driver's License and car insurance.
• MSW and;current and unrestricted LICSW/LSW in South Carolina (in lieu of RN license).
• Current and unrestricted Registered Nurse license in South Carolina strongly preferred

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Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at;www.amerihealthcaritas.com.

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Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

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