Manager - Care Management
Department: Market Ops - Rhode Island | Location: 1301 Atwood Avenue, Suite 206N, Johnston, RI 02919 | Compensation: $100,000 - $150,000 per year
About the Role
We are currently seeking a highly motivated Manager, Care Management to support our Health Services Outpatient Care Management team at Astrana Health. This role is responsible for managing telephonic and in-home Care Management services and activities for high-risk patients, with the primary goal of preventing unnecessary utilization and improving patient outcomes. This position will lead a multidisciplinary clinical team, including providers, registered nurses, social workers, community health workers, and care coordinators. The ideal candidate is a strong people leader with deep care management expertise, a passion for serving complex patient populations, and a commitment to advancing value-based care.
Our Values
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
Responsibilities
- Manage clinical services, including oversight of clinical policies, procedures, and daily activities of clinical team staff
- Ensure adequate staffing to conduct care management activities and effectively distribute workloads
- Ensure team members receive appropriate training to serve the population and demonstrate effective engagement activities for individuals with various disabilities, including chronic physical and behavioral health conditions
- Ensure Integrated Clinical Services staff are trained on NCQA and HEDIS measures and processes to maintain compliance
- Ensure all programs and clinical operations are in full compliance with state and federal regulations, including HIPAA
- Ensure compliance with emergency management policies, procedures, and processes by serving as a liaison with other business units
- Monitor the effectiveness of existing