Manager of Case Management (RN or LMSW)

Location: Troy, MI
Date Posted: 12-31-2018
RN or LMSW Manager of Case Management - Managed Care
Troy, MI (Northern suburb of Detroit)
Manager of Case Management Job Summary:
  • Manager of Case Management provides clinical leadership for all Care Coordination programs by serving as an educator, role model, member advocate, and change agent to enhance member care and staff competency. 
  • Provides clinical guidance and supervision to all case management programs, based on accepted principles of nursing, social work, gerontology, geriatrics and case management practice.  
  • Develops, manages and participates in departmental projects, workflow processes, policies and procedures in collaboration with internal and external stakeholders. 
  • Ensures availability of specialized expertise to Medical Management programs by identifying case management needs and identifying and training subject matter experts.  
  • Uses a collaborative approach with the case management team in order to revise, develop, and implement cost savings methodologies and interventions. 
  • Facilitates communication with providers to ensure continuity of care and coordination between multiple specialists, providers, and vendors.   
  • The manager will ensure that policies and procedures are developed and enforced in alignment with the standards of patient care and regulatory bodies and that the core components of the case management process are followed.
Manager of Case Management Background:
  • Valid, unrestricted state Registered Nurse (R.N.) license or Licensed Master's Social Work (L.M.S.W)
  • Requires a Bachelor degree in nursing, healthcare, or related field; Master’s degree in preferred.
  • Roughly 3-5 years of recent acute care clinical nursing experience.
  • Minimum of 3-5 years’ Case Management or Disease Management experience; Certified Case Manager, (CCM) preferred.
  • Around 5 years’ experience at a health plan or other managed care organization (HMO/TPA/IPA/etc).
  • Minimum 2-3 years of healthcare or health plan supervisory or managerial experience, including oversight of clinical staff.
  • Prefer Medicaid/Medicare Population experience with increasing responsibility.
  • Experience in training / teaching staffs to meet operational requirements and goals.
  • Strong oral and written communication skills; ability to interact with all levels of internal and external contacts.
480.646.3275 (CALL – TEXT – FAX)
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