Manager, Case Management

Yakima, WA

Posted: 03/27/2019 Category: Registered Nurse Job Number: 21726

Manager, Case Management

Location: Yakima, Washington

Salary: $74, 500.00 - $104, 000.00

Benefits and yearly bonus structure

 

Job description:
  • Perform duties to conduct and manage the day to day operations of the case management functions communicating with departmental and plan administrative staff to facilitate daily department functions.
  • Review analyzes of activities, costs, operations and forecast data to determine progress toward stated goals and statistical/financial purposes.
  • Promote compliance with federal and state regulations and contractual agreements.
  • Develop, implement and maintain compliance with policies and procedures regarding medical case management.
  • Develop, implement, and maintain case management programs to facilitate the use of appropriate medical resources and decrease health plan financial exposure. Facilitate on-going communication between case management staff, members, contracted providers, and subsidiaries.
  • Develop staff skills and competencies through training and experience.

 

Qualifications:
  • Bachelor’ s degree in Nursing or equivalent experience.
  • 3+ years case management experience and recent nursing experience in an acute care setting particularly in medical/surgical, pediatrics, or obstetrics and management experience.
  • Thorough knowledge of case and/or utilization management and clinical nursing.
  • Familiarity with Medicaid managed care practices and policies, CHIP, and SCHIP.
  • Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.
  • Unrestricted RN license in applicable state(s)
  • Case Management Certification (CCM) preferred.

If you are interested in setting up a phone interview screening please contact Ashley at 877-782-3334 or email akruger@alinestaffing.com

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