Manager, Case Management- Bakersfield 1.1

Description

Location: Bakersfield, CA. (Onsite)

Classification: Full-Time

This position is exempt and will be paid on a salary basis. 

Schedule: Monday-Friday 8am-5pm

Benefits:

· Medical 

· Dental 

· Vision 

· Paid Time Off (PTO)

· Floating Holiday 

· Simple IRA Plan with a 3% Employer Contribution

· Employer Paid Life Insurance

· Employee Assistance Program

Compensation: The initial pay range for this position upon commencement of employment is projected to fall between $61.01 and $ 76.25. However, the offered base pay may be subject to adjustments based on various individualized factors, such as the candidate's relevant knowledge, skills, and experience. We believe that exceptional talent deserves exceptional rewards. As a committed and forward-thinking organization, we offer competitive compensation packages designed to attract and retain top candidates like you.

Position Summary:  

The Manager of Case Management, under the supervision of the Director of Clinical Programs, is responsible for the day-to-day operations of the Enhanced Care Management (ECM) Program, including the oversight of case management activities, reporting, training, and compliance. The  Manager is responsible for addressing and resolving variances in care services that could  potentially result in regulatory non-compliance and negative patient health outcomes. The ECM  Program addresses the clinical and non-clinical needs of members with the most complex  medical and social needs through systematic coordination of services and comprehensive care  management. ECM is intended to service those with chronic health conditions, are homeless or  at-risk, with high hospital admissions, substance abuse, and/or behavioral health needs. This position requires a leader with strong interpersonal skills, critical thinking, building skills, ability to effectively lead a high-performing team, and foster continuous learning. 

Requirements

 Job Duties and Responsibilities:

• Provide supervision, training, resources, monitoring and mentoring to the clinical and non-clinical staff within the ECM Program per departmental policies and health plan requirements.  

• Develop, maintain, and communicate Case Management Policies and with ongoing monitoring of departmental and staff adherence and compliance. 

• Perform case audits to verify consistency and effectiveness of compliance with standards of care, documentation, and provision of services. 

•Provide clarification and interpretation of ECM Program guidelines, standards, goals, and expectations. 

• Collaborate with other disciplines, oversees the development, implementation, monitoring, and modification of the plan of care for the member through a collaborative and interdisciplinary team approach. 

• Facilitate interdisciplinary care meetings and assist in identifying opportunities for care.  

• Manage and monitor case assignments and ECM staff caseload management. 

• Provide education to Case Management staff related to member assessment completion and care plan development and follow-up according to ECM policy guidelines. 

• Manage reports and assist in data gathering and analysis and makes recommendations for program process improvements. 

• Review and audit monthly billing Case Management. 

• Maintain time and attendance for designated employees. 

• Facilitate and participate in audit reviews and corrective action plan development and implementation. 

• Responsible for tracking and responding to feedback received internally and externally regarding Case Management services and employees. 

• Establishes orientation and training plans for Case Management staff to promote consistency in program delivery. 

• Manage and participate in new hire processes and employee evaluation processes. 

• Collaborate with Medical Management Director and leadership team regarding service objectives. 

• Perform other duties and projects, as assigned. 

 Qualifications: 

• Licensure: Current California RN license required. 

• A bachelor's degree in nursing from an accredited school of nursing, or years of experience in lieu of degree will be considered. Master’s degree preferred. 

• Minimum of two (2) years management or supervisory experience. 

• Demonstrated experience working with one or more of the ECM populations of focus,  including but not limited to: adults and children experiencing homelessness, those with  serious mental illness (SMI) or substance use disorders (SUD), high-utilizers of  healthcare services, adults or children with complex physical, behavioral, or  developmental conditions, individuals transitioning from incarceration, children/youth  involved in child welfare, or those belonging to the birth equity population.