Manager, Care Management Services

About the role

HPI is a respected industry leader with over 44 years of experience, offering health and benefit solutions as a third‑party administrator. The Manager of the Case Management (CM) Team provides day‑to‑day oversight of the Case Management program, promotes cost‑effective health resource management, and works to meet individual members’ health care needs while driving positive health outcomes.

Responsibilities

• Participate in orientation and mentoring of new employees.
• Perform monthly audits of designated team members.
• Hold monthly 1:1 meetings with designated team members.
• Complete annual performance reviews for designated team members.
• Manage daily schedule for the CM team, including PTO requests and timesheets.
• Collaborate daily with the CM team to balance caseloads, assist in problem solving, and provide mentoring.
• Work with the Director on employee performance issues, escalated member/case issues, and maintaining up‑to‑date processes and workflows.
• Communicate with members, physicians, and other health‑care professionals about the Care Management process, policies, procedures, benefit coverage, and determinations.
• Collaborate with other HPI departments for issue resolution and process improvements.
• Attend meetings as requested by the Chief Clinical Officer or the Director.
• Stay current on URAC standards and Utilization Management Policies & Procedures.
• Advocate for and promote the case management program.

Requirements

• Associate’s degree in nursing.
• Active, current, and unrestricted Registered Nurse compact license (or state of residency license).
• 5+ years of clinical experience.
• 3+ years of experience as a Case Manager.

Qualifications

• Certified Case Manager (CCM) – preferred.
• Bachelor’s degree – preferred.
• Supervisory experience.

Benefits

• Medical, dental, vision, and prescription drug coverage.
• Fitness reimbursement benefit.
• Employee Assistance Program.
• Flexible Spending Account & Health Savings Account.
• 401(k) plan and quarterly bonuses.
• Generous paid‑time off and volunteering opportunities.
• Educational assistance and professional development opportunities.

Why choose us?

We are a people‑first company that values integrity, flexibility, loyalty, compassion, and dedication. Our Westborough headquarters feature an onsite café, walking trails, and campus gyms. We embrace a “smart casual” dress code, ergonomic workstations, and a supportive, inclusive environment that encourages innovation and growth. Volunteer opportunities are available for those who want to give back to the community.