Clinical Care Manager

About the role

The Care Manager for the Care Management Programs (APCM, PIN, CHI, BHI, and CCM) is driven by the need for strategic oversight of care coordination efforts. The Care Manager will provide leadership and supervision to care coordinators responsible for managing patient-centered care plans, ensuring program goals are achieved. This role is vital for maintaining high-quality care, improving patient outcomes, and ensuring compliance with regulatory standards across all care management programs.

Responsibilities

• Provide leadership and direction to care coordinators responsible for patient-centered care plans.
• Review care coordinators' activities to ensure compliance with established protocols and regulatory requirements.
• Monitor the quality and effectiveness of care coordination to ensure alignment with program goals.
• Hire, train, and mentor care coordinators, fostering professional development and accountability.
• Conduct regular performance evaluations and provide feedback to improve team effectiveness.
• Oversee operations for APCM, PIN, CHI, BHI, and CCM programs, ensuring integration across care management initiatives.
• Monitor program metrics and outcomes, implementing changes to improve performance and patient satisfaction.
• Ensure care coordinators are effectively engaging patients and addressing barriers to care.
• Advocate for the integration of community and behavioral health resources into care plans.
• Oversee care management strategies to support patients with chronic conditions, ensuring preventive measures and care plans are executed.
• Guide care coordinators in managing navigation of complex illnesses, ensuring timely referrals and interventions.
• Ensure care coordinators collaborate with community organizations to address social determinants of health, such as housing, food security, and transportation.
• Supervise the integration of behavioral health services into care plans, ensuring collaboration between mental health providers and care coordinators.
• Oversee the management of chronic care plans, ensuring care coordinators effectively track and document patient progress.
• Ensure compliance with healthcare regulations, including Medicare, Medicaid, and HIPAA compliance.

Requirements

• Bachelor’s Degree in Healthcare Administration or Bachelor’s Degree in Nursing (BSN) or Associate Degree in Nursing (ADN) or International Medical Graduate, or a related field (required).
• Expertise in program evaluation, quality improvement, and process optimization.
• Familiarity with care management software, data analytics, and population health tools.
• Strong documentation skills and attention to detail for compliance and reporting.

Qualifications

• Strong leadership and supervisory skills with the ability to mentor and guide care coordinators.
• Knowledge of healthcare regulations, including Medicare, Medicaid, and HIPAA compliance.
• Preferred Certifications: Case Manager Certification (CCM), Certification in Population Health Management or Behavioral Health Integration.

Skills

• Strong leadership and supervisory skills with the ability to mentor and guide care coordinators.
• Expertise in program evaluation, quality improvement, and process optimization.
• Knowledge of healthcare regulations, including Medicare, Medicaid, and HIPAA compliance.
• Familiarity with care management software, data analytics, and population health tools.
• Strong documentation skills and attention to detail for compliance and reporting.

Benefits

Essen Health Care is committed to providing a comprehensive benefits package that includes:

• Health insurance
• Paid time off
• Retirement savings plan
• Professional development opportunities

Pay

$65,000.00 - $70,000.00 Annually

Schedule

Full-time position

Contact

For more information about this position, please contact [Contact Information].