Mgr, Integrated Care Mgt - MLTSS

Location
Virginia Beach, VA
Posted
Feb 21, 2017
Closes
Apr 04, 2017
Function
Nurse
Industry
Healthcare
Hours
Full Time
Job Description: The MLTSS Care Coordination Manager is the clinical subject matter expert that is responsible to supervise, direct and evaluate an interdisciplinary clinical team to assure effectiveness of care coordination activities, routinely assessing and monitoring members¿ status, needs and progress. Responsible for operational components of the Healthcare Management Program, as well as, oversight of utilization management functions and the case management program in accordance to contractual agreements. Will develop and oversee all program clinical operations across all markets with a focus on program development, program enhancements, managing interdependencies and risks, program status and evaluation, program growth/expansion in both new and existing markets.

Education Level
RN-Bachelor's Level Degree

Experience
Required: Long Term Care Management - 3 years; Medicaid - 3 years

License
None unless noted in “other” below

Skills
None unless noted in “other” below

Other
Proven ability to drive clinical teams toward a culture of compliance, strategic and organizational agility, and mastery of engaging and developing staff policies.
Knowledge and experience with regulations and best practices applicable to care management of vulnerable populations.
Extensive knowledge of regulatory requirements and policy coverage guidance applicable to Medicaid/Medicare utilization management.