Senior Director, Case Management

Lenexa, KS

Posted: 04/30/2019 Job Number: 27586
Position Purpose:
  • Oversee case management operations for the health plan.
  • Define and direct the case management program for the plan in conjunction with corporate goals and objectives.
  • Lead and direct the overall operation of the case management function to ensure consistency of policies, procedures and work flows.
  • Ensure member and provider satisfaction with case management program.
  • Evaluate case management program effectiveness and recommend improvements.
  • Ensure case management targets for all products are met for the annual operating plan, state requirements and financial management
  • Ensure that utilization management process is integrated with case management program.
  • Maintain compliance with National Committee for Quality Assurance (NCQA) standards for case management function.
  • Identify quality and risk management issues and facilitate the collection of information for quality improvement and reporting.
  • Review various reports and identify trends to assist in financial forecasting.
  • Education/Experience: Bachelor' s degree in Nursing, related field, or equivalent experience.
  • 7+ years of nursing experience in an acute care setting or complex case management experience.
  • Experience in managed care environment.
  • License/Certification: RN license.
For more information on this position, please contact our office at 877-782-3334.

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