Case Management Director jobs in Sumter, SC

Case Management Director oversees a staff of case managers responsible for patient care coordination. Develops and implements case management programs, including utilization review, intake or discharge planning, and managed care contracting or negotiation. Being a Case Management Director evaluates patient care data to ensure that care is provided in accordance with clinical guidelines and organizational standards. Seeks treatments that balance clinical and financial concerns with the family's needs and the patient's quality of life. Additionally, Case Management Director contributes to the development and improvement of clinical care pathways that enhance cost effectiveness while providing quality care. Typically requires a bachelor's degree. Typically reports to top management. May require Registered Nurse (RN). The Case Management Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Case Management Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Case Management Associate (Bi-Lingual, Remote)
  • ProgenyHealth
  • Alcolu, SC FULL_TIME
  • Job Role

    The Case Management Associate will assist the Case Management department in the administration of CM functions to include, telephonic follow-up to members; monitor member eligibility; updating database information and research of support services for families. This is a full-time, remote position with five 8-hour work days per week, between the hours of 8:30 am to 7:00 pm Monday-Friday.

    Job Responsibilities:

    • Coordinates with the Case Managers in follow-up outreach to unenrolled families
    • Track and document status of case in database
    • Communicate basic program information to families and facilitate follow-up call by Case Manager
    • Monitor member eligibility
    • Update database with member demographic information
    • Research support groups, member resources and provider information
    • Facilitate case closures
      .

    Qualifications

    • 1 – 3 years of experience in customer service in a healthcare environment.
    • HS diploma or equivalent required. College degree preferred.
    • Must be fluent in English. Fluent in Spanish is desired.
    • Insurance/payor experience preferred.
    • Professional verbal and written communication skills, with the ability to clearly articulate thoughts and ideas as well as interact professionally and effectively with members, clients, and staff from all departments within and outside the company.
    • Problem solving skills with the ability to look for root causes and implementable, workable solutions.
    • Must be proficient at an intermediate to advanced level in Outlook, Excel, PowerPoint, & Word.
    • Must be self-motivated and willing to learn multiple tasks.
    • Must be well-organized and able to prioritize tasks.
    • Must have commitment to excellence in customer service.

    Benefits/Culture

    Our team is our most important asset. some of the benefits we offer our team are:

    • 401K with company match
    • Medical and dental benefits
    • Long Term Disability
    • Paid Time Off

    ProgenyHealth positively recruits people from diverse backgrounds, including individuals with disabilities - if you need an accommodation to interview, please contact us by email: careers@progenyhealth.com

  • 6 Days Ago

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Labor and Delivery Nurse Director
  • Clinical Management Consultants
  • Andrews, SC FULL_TIME
  • A top-notch hospital is actively interviewing for a Women and Children's Services RN Director to lead this robust service line. This is a wonderful opportunity for an experienced Labor and Delivery Nu...
  • 6 Days Ago

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Women and Children's Services RN Director
  • Clinical Management Consultants
  • Andrews, SC FULL_TIME
  • A top-notch hospital is actively interviewing for a Women and Children's Services RN Director to lead this robust service line. This is a wonderful opportunity for an experienced Labor and Delivery Nu...
  • 2 Months Ago

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Registered Nurse (RN) - Hospice Case Management - Full-Time Day
  • 267 Prisma Health Tuomey
  • Sumter, SC FULL_TIME
  • Inspire health. Serve with compassion. Be the difference. Job Summary The hospice registered nurse utilizes the nursing process to provide hospice and palliative care to the terminally ill patient, re...
  • 27 Days Ago

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RN Case Manager
  • Patriot Hospice
  • Turbeville, SC FULL_TIME
  • Position SummaryThe primary purpose of your job position is to provide, coordinate, and direct the provision of hospice services according to physician’s orders and patient plan of treatment based on ...
  • 1 Month Ago

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Correctional Treatment Specialist (Case Manager)
  • U.S. Department of Justice
  • Salters, SC FULL_TIME
  • Summary Corrections professionals who foster a humane and secure environment and ensure public safety by preparing individuals for successful reentry into our communities. Our highly-skilled, diverse,...
  • 16 Days Ago

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0 Case Management Director jobs found in Sumter, SC area

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English Instructor
  • State of South Carolina
  • Sumter, SC
  • Salary: Depends on Qualifications Location : Sumter County, SC Job Type: FTE - Full-Time Job Number: 164365 Agency: Cent...
  • 5/7/2024 12:00:00 AM

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Microbiology Environmental Monitoring Trainer
  • Nephron Pharmaceuticals
  • West Columbia, SC
  • Corporate Statement Nephron Pharmaceuticals Corporation is a privately owned, global leader in the manufacturing of gene...
  • 5/6/2024 12:00:00 AM

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QC Microbiology Analyst I
  • Nephron Pharmaceuticals
  • West Columbia, SC
  • Corporate Statement Nephron Pharmaceuticals Corporation is a privately owned global leader in the manufacturing of gener...
  • 5/6/2024 12:00:00 AM

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Part-Time Security Officer
  • State of South Carolina
  • Sumter, SC
  • Salary: $11.00 Hourly Location : Kershaw County, SC Job Type: Temporary - Part-Time Job Number: 157985 Agency: Central C...
  • 5/5/2024 12:00:00 AM

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Managing Director
  • Transamerica Premier Life Insurance Company
  • Columbia, SC
  • The Managing Director is responsible for growing the business of the District Office by developing new quality sales, co...
  • 5/4/2024 12:00:00 AM

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Executive Director / Program Manager III - Spartanburg Area Mental Health Center
  • State of South Carolina
  • Columbia, SC
  • Salary: $81,388.00 - $150,585.00 Annually Location : Spartanburg County, SC Job Type: FTE - Full-Time Job Number: 164381...
  • 5/4/2024 12:00:00 AM

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Academic Program Manager, Computer Science
  • State of South Carolina
  • Sumter, SC
  • Salary: Depends on Qualifications Location : Sumter County, SC Job Type: FTE - Full-Time Job Number: 160754 Agency: Cent...
  • 5/4/2024 12:00:00 AM

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Compliance Analyst - Deposit Operations
  • Safety National
  • Sumter, SC
  • SUMMARY Under the supervision and oversight of the AVP of Compliance, the Compliance Analyst is responsible for assistin...
  • 5/3/2024 12:00:00 AM

Sumter /ˈsʌmtər/ is a city in and the county seat of Sumter County, South Carolina, United States. Known as the Sumter Metropolitan Statistical Area, the namesake county adjoins Clarendon and Lee to form the core of Sumter-Lee-Clarendon tricounty area of South Carolina that includes the three counties in the east central Piedmont. The population was 39,643 at the 2000 census, and it rose to 40,524 at the 2010 census. Known as the Gamecock City,[citation needed] Sumter lies near the geographic center of the state of South Carolina at 33°55′37″N 80°21′49″W / 33.92694°N 80.36361°W / 33.92694; ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Case Management Director jobs
$135,027 to $189,612
Sumter, South Carolina area prices
were up 1.5% from a year ago

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