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Clinical manager - Care Management

Boston, MA · Healthcare

An awesome opportunity to lead a care management team for a rapidly growing tech-enabled care management company.

100% Remote role

Reporting to the Director, Care Management, the Manager is responsible for directing care management operations and leading a team to deliver services that engage, motivate, and educate family caregivers to support complex individuals, keeping care at home.

This individual ensures the delivery of high-quality services in compliance with all state, program, and accreditation requirements. This individual will manage a team of clinical and non-clinical care managers, providing case management services across the continuum of care (assessment, care planning, care coordination, and monitoring and evaluating services).

In collaboration with key stakeholders, this individual will create action plans in support of quality improvement efforts and positive health outcomes.

 

Responsibilities:

  • Respond to requests from caregivers and consumers and communicate with team members regarding concerns or emerging issues
  • Track consumer risk and work with care teams to adjust the plan of care (POC) as appropriate
  • Manage the case conference process, facilitating case review as well as discussion of risk mitigation strategies and follow-up
  • Resolve and respond to complaints or grievances expressed by consumers or caregivers or their stakeholders
  • Drive effective utilization of established best practices and protocols across the team, ensuring compliance with contractual obligations and NCQA accreditation requirements; observe virtual/home visits with care management team members and review documentation for quality
  • Coach and mentor care team members and identify individual or team training needs; provide training to new clinical team members and others as needed
  • Assist with incident investigations and reporting
  • Ensure continuous survey and audit readiness, maintaining compliance with company policies and practices as well as federal/state/local regulations
  • Will supervise clinical and non-clinical care managers
  • Perform other projects and duties as assigned

What You Will Bring:

  • Bachelor’s degree or equivalent
  • Minimum of 4-6 years of experience in case management and care planning for older adults with complex medical conditions and/or individuals with disabilities, preferably in a health care, long-term care, social service or community setting.
  • An active RN Massachusetts license is required
  • Demonstrated ability to coach and mentor others
  • Working knowledge of case management systems, community service and delivery systems, and Microsoft Office suite
  • Ability to travel occasionally

 

 
 
 
Contact information:
________________________________________________
 
Recruiter
Max Populi, LLC
4628 Bayard Street, #207
Pittsburgh, PA 15213-2750
Tel: (412) 567-5279
Fax: (412) 567-5198
e-mail: jobs@maxpopuli.com
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