Manager, Care Management

New
  • Location
    Camarillo, California
  • Job type
    Direct Hire
  • Category
    Medical & Science - Nursing

Manager, Care Management


Adecco Medical & Science is seeking a competent Manager, Care Management candidate to work for one of our customers in beautiful Camarillo, Ca! This is a direct hire full time position, with a company that manages Medi-Cal benefits to their members.


The Manager, Care Management, is responsible for the development of a comprehensive program to coordinate medical and social services that lead to the cost effective management of health care resources that meet the individual members' health care needs. The program will promote positive health outcomes; provide support to the member and member"s care team by acting as an advocate and a liaison between providers, members and the company to seamlessly integrate complex services. The program will include mechanisms to identify members who can benefit from care coordination services with a resulting improvement in health status and a reduction in the consumption of health care services. The Manager, Care Management, will mentor staff through use of her clinical judgment, independent analysis, and critical-thinking skills and through development of a cohesive team environment.





ESSENTIAL FUNCTIONS
Reasonable Accommodations Statement
To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

Essential Functions Statement(s)

Participate in the development of programs to proactively identify members at risk who are appropriate for care management services.
Develop protocols to review, screen and prioritize cases for possible case management services.
Develop tools to ensure the delivery of comprehensive case assessment services.
Mentor staff to ensure protocols are being followed and that Care Management services are efficient and effective.
Identify problems through dialog with staff and institutes solutions that improve or correct deficiencies.
Ensure staff are included in department decisions to ensure support for new processes.
Develop auditing methodologies to provide feedback to staff on areas where improvements may be needed.
Identify deficiencies in appropriate health care resources and works with other Gold Coast Departments to resolve issues.
Develop an annual Care Management Plan that outlines the goals and objectives of the Care Management Department.
Continually reassesses department staffing needs to ensure adequate resources are available.

POSITION QUALIFICATIONS
Competency Statement(s)

Management Skills - Ability to organize and direct oneself and effectively supervise others.
Presentation Skills - Ability to effectively present information publicly.
Detail Oriented - Ability to pay attention to the minute details of a project or task.
Team Builder - Ability to convince a group of people to work toward a goal.
Conflict Resolution - Ability to deal with others in an antagonistic situation.
Goal Oriented - Ability to focus on a goal and obtain a pre-determined result.
Diversity Oriented - Ability to work effectively with people regardless of their age, gender, race, ethnicity, religion, or job type.





Travel; work protracted and irregular hours and evening meetings, or work unusual hours for meeting attendance or participation in specific projects or programs.





SKILLS & ABILITIES
Education: Bachelor degree or higher required.
Higher education preferred.

Experience: 5 plus years of experience in acute inpatient clinical care.
5 plus years of experience in managed care.

Computer Skills: Proficient in computer programs included in the MS Office products.

Certifications &
Licenses:
CCM certification preferred




Other Requirements:


Strong knowledge federal and state regulations/requirements related to MediCal and MediCare.
Extensive knowledge of Care Management Principles. Strong analytical and problem solving skills required. Strong organizational skills.
Ability to effectively analyze, interpret, apply and communicate policies, procedures and regulations.

PHYSICAL DEMANDS
N (Not Applicable) Activity is not applicable to this position.
O (Occasionally) Position requires this activity up to 33% of the time (0 - 2.5+ hrs/day)
F (Frequently) Position requires this activity from 33% - 66% of the time (2.5 - 5.5+ hrs/day)
C (Constantly) Position requires this activity more than 66% of the time (5.5+ hrs/day)






Physical Demands
Stand



F


Lift/Carry
10 lbs or less



C




Walk


F


11-20 lbs


C




Sit


F


21-50 lbs


F




Manually Manipulate


F


51-100 lbs


N




Reach Outward


F


Over 100 lbs


N




Reach Above Shoulder


O










Climb
Crawl


O
N


Push/Pull
12 lbs or less



C




Squat or Kneel


O


13-25 lbs


C




Bend


O


26-40 lbs


F




Grasp


F


41-100 lbs


O




Speak


F











Other Physical Requirements

Vision (Near, Distance, Color, Depth)

WORK ENVIRONMENT
Office work environment.




To inquire about the position, please contact Amber Helmuth at amber.helmuth@adeccona.com

  • Apply with Adecco

Reference number US_EN_2_108175_325227