Case Management Lead (remote)

2017-1262
US-Remote
Category
Public Health
Type
Regular Full Time

Overview

Karna, LLC is seeking Lead Case Managers for an upcoming remote opportunity with our HHS client. The Case Management Lead is directly responsible for the management and oversight of Care Management functions and ensures professional and consistent application of case management standards.

Responsibilities

Job Responsibilities: 

  • Provide management oversight of the case management team and operations to ensure efficiency and effectiveness of the case management program
  • Responsible for developing programs to improve Care Management and assist case managers and their support system to become engaged in a collaborative process designed to manage medical/social/mental health conditions for members more effectively
  • Design case management program to enhance consistency in services provided and reporting
  • Outlinee and definee the key components of a comprehensive care management program and provide examples of tools and strategies to effectively meet the needs of members with complex and special needs
  • Build a comprehensive care management plan and aligning the work force to the appropriate initiatives and measures
  • Work collaboratively with executive leadership, medical directors, operations, provider network, government products, project management and informatics to identify, develop, implement and monitor programs and processes
  • Report program effectiveness and metrics to the executive leadership
  • Proven ability to understand Care Management trends and to develop initiatives designed to bend trend while insuring appropriate access to quality care
  • Lead and motivate clinical and administrative staff to achieve specific objectives
  • Understand and analyze complex business problems and apply cost effective solutions

 

Qualifications

  • BSN from accredited university
  • Minimum 2 years' experience in supervisory / management role
  • Minimum 4 years' experience in Utilization Management, Case Management and/or Quality Management
  • Minimum 5 years' clinical experience
  • Experience with oncology and/or complex case management preferred
  • Current RN License
  • Certification of Case Management (CCM) strongly preferred
  • Demonstrated knowledge of managed care including of the physician, provider, payer, and employer perspectives 
  • Ability to work well with diverse groups of individuals
  • Ability to deal sensitively and diplomatically with difficult situations
  • Advanced MS Office skills 
  • Excellent communication and negotiating skills 

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