Quality Improvement Manager - Case Management

As a Quality Improvement Manager - Case Management, you will be responsible for operational management of case management programs, account management, and business development for specific healthcare contracts.  Operational management includes team accountability for evaluation measures, deliverables or project requirements. You will be responsible for monitoring compliance in accordance with client and contract deliverables as well as service/accreditation requirements as applicable.  

Essential Functions

• You will manage the day to day operations of health management lines of service and/or contracts/programs, with particular emphasis on case management programs and care coordination initiatives. You will lead a team in the creation of a strategic plan, implementation of plan, evaluation and ongoing management to ensure contract deliverables/program requirements and evaluation measures/metrics are met and/or exceeded within assigned funding/budget.  When deliverables/requirements are at risk, you will facilitate analyses and initiate action plans.
• You will develop and maintain relationships with team stakeholders.  You will provide technical assistance, including issue research and resolution. You will develop and implement process improvement methods for an organization whose philosophy is continual improvement. You will ensure operations are completed in a timely, satisfactory, compliant manner within assigned funding/budget.
• You will participate in sales, business development and proposal work activities including development of concept papers, contributing content or review of proposals as a subject matter expert.  You will also have financial accountability for monitoring budgets and financials for assigned contracts.
• You will coach, guide and directs team members to achieve individual, team and organizational objectives. You will provide resources and support as needed to meet the departmental and Company goals and specific contract/program requirements.
• You will represent the company and presents at meetings and/or conferences. You will work externally with providers or clients as assigned. You will make recommendations for improvements and/or efficiencies to management.  You will Initiate opportunities to expand knowledge, skill development, and certifications which enhance quality improvement activities and the achievement of contract deliverables.
• You will stay abreast of industry trends and changes. Performs miscellaneous duties as assigned.

Requirements

• Four year degree in nursing, health care, business, public health or a related field and/or equivalent training and/or experience;  
• Current and unencumbered RN license; 
• 5 years experience in a healthcare environment with demonstrated expertise in care management, care coordination, and/health care quality improvement, including experience with case management and evidence-based clinical guidelines;
• 3 – 5 years managing projects and/or a professional staff;
• Demonstrated experience working in a fast paced and deadline driven environment;
• Positions working on specific contracts may require U.S. Citizenship.

Preferred Qualifications

• Experience with case management models and interventions
• Knowledge of care coordination best practices and transitions of care
• Familiarity with population health stratification and risk assessment tools
• Understanding of care management metrics and outcomes measurement
• CCM (Certified Case Manager) certification or have the ability to obtain certification within 2 years of hire

Who We Are: Telligen is one of the most respected population health management organizations in the country.  We work with state and federal government programs, as well as employers and health plans offering clinical, analytical, and technical expertise. Health has changed a lot through our 50-year history, but what has remained constant is that we care deeply about who we serve and what we do. Our success is built on our ability to adapt, respond to client needs, and offer innovative solutions. Our business is our people and we’re looking for talented individuals who not only believe in our mission but who are ready to take ownership and make a difference in the lives of people, in the world of health. Learn more about who we are and what we do at www.telligen.com/about-us Are you Ready? We’re on a mission to transform lives and economies by improving health and getting there means following through on our values of Ownership, Community, Ingenuity & Integrity.  Ownership: As a 100% employee-owned company, our employee-owners drive our business, our solutions, and share in our success. When employee-owners grow and thrive, we all win.Community: Putting others first and being a good corporate partner wherever we work, and play makes us who we are. We Show Up. For our clients, for our communities, and for each other.Ingenuity: We’re a team of passionate professionals driven by hard work and big ideas. We understand that high-value breakthroughs come from taking calculated risks. If it will benefit our clients and advance our mission, we’re all ears. We celebrate free-thinking and challenge the status quo, so brainstorm away! Integrity: Smiling faces (virtual or in-person) are the norm around here. We enjoy a friendly work environment where everyone is dedicated to mutual trust, respect, and excellence.  Thank you for your interest in Telligen!Follow us on Twitter, Facebook, and LinkedIn to learn more about our mission-driven culture and stay up to speed.
While we use artificial intelligence tools to enhance our initial screening process, all applications are thoroughly reviewed by our human recruitment team to ensure a fair and comprehensive evaluation of each candidate.As part of our commitment to health and safety, some roles may require additional health protocols (i.e. personal protective equipment or vaccination).Telligen and our affiliates are Affirmative Action, Equal Opportunity Employers, and E-Verify Participants. Telligen will not provide sponsorship for this position. If you will require sponsorship for work authorization now or in the future, we cannot consider your application at this time. Telligen does not accept 3rd party solicitations from outside staffing firms.