Manager, Case Management

Hybrid - 80% travel required (Monday-Friday 8:00 AM-5:00 PM)

Job Summary:

The Manager of Community Teams is a key leader of the integrated community care team and provides clinical and performance oversight of a community care management team that is comprised of complex care managers, care team coordinators and community health workers. This role understands the complexities of co-occurring conditions and social determinants of health (SDoH), how they impact the overall health and wellbeing of our members and strategically identifies and implements integrated processes to improve outcomes. The MCT is responsible for the daily operations of the community care management team based on key performance indicators that include reducing potentially preventable events (e.g., ER visits, hospital admissions), increasing medication adherence, stabilizing chronic conditions and improving self-management, overcoming barriers to care and SDoH needs including housing, food and financial instabilities, increasing member engagement with community resources, and member retention.

Experience and Experience:

• Lead a care management team comprised of licensed registered nurses, social workers, community care team coordinators and community health workers.
• Closely collaborate with the general manager, community team and medical center counterparts to deliver integrated care across the continuum from community to shared services at the center.
• Analyze data to design, implement and measure processes that increase positive health outcomes as evidenced by overall health care cost and utilization reduction.
• Oversee clinical staff development and performance that results in person-centered care planning, SMART goals, clear and consistent documentation, use of evidence-based disease management and chronic care protocols in combination with therapeutic approaches to care including motivational interviewing, trauma informed care, and harm-reduction strategies.

Minimum Qualifications:

• Clinically licensed in the state of practice with 5 years of supervisory experience in care management related field including insurance case management, hospital case management or ambulatory care management:
• Licensed clinician (RN, LCSW, LMSW, LMHC, LPC) by the state in which practicing and abide by all laws, regulations, and requirements. Preference given to qualified case managers with CCM or CMAC credentials. CMGT-BC, CCTM, C-SWCM, C-ASWCM, ACM or FAACM will be considered.
• Preference given to RN candidates with experience in behavioral healthcare or PMH-BC credentialed –or– SW/Counselor candidates with experience in medical settings or medical case manager roles (Infectious Disease, HIV, Hepatitis C, Organ Transplants).
• In lieu of CCM credential, 5 integrated case management experience. Must obtain CCM within 24 months of hire date.
• Qualified clinical supervisors will be given preference.
• 3 years of experience serving the needs of complex populations, including medically complex, trauma history, mental health conditions, substance abuse, and socioeconomic barriers in an office or community-based setting.
• Preference given to qualified candidate with multiple settings experience (Inpatient, LTPAC, home health, corrections, community programs and/or human service agencies.)
• Experience with complex government-sponsored populations preferred, e.g., Medicaid, Medicare beneficiaries.
• Experience with member engagement, transitions of care, clinical care, and/or case management
• Advanced computer skills with proficiency in Outlook, Word, Power Point, Excel.
• Experience working in multiple electronic health records.

Job Type: Full-time

Pay: $105,000.00 - $115,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Supplemental pay types:

• Signing bonus

Ability to Relocate:

• Baltimore, MD 21201: Relocate before starting work (Required)

Work Location: In person

Salary : $105,000 - $115,000