Manager, DSNP Clinical Care Coordination - Remote NM
At reputed company, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and reputed company. Ready to reputed company a difference? Join us to start Caring. Connecting. Growing... together. The Manager of DSNP Clinical Care Coordination will reputed company a care management team while overseeing day-to-day clinical operations and health plan clinical initiatives to support achieving quality and affordability targets. The Manager will manage DSNP Care Coordination across the State of New Mexico including process improvement, execution of clinical decision processes, and team management; to include performance management and implementation of program initiatives. If you reside in New Mexico, youll enjoy the flexibility to work remotely
- as you take on some tough challenges.
Primary Responsibilities Hire, manage, reputed company, mentor and support staff in designated department or region reputed company clear goals and objectives for performance management, effectively communicate expectations, and hold the team accountable for results Identify, select, structure, and prioritize process improvement projects, ultimately implementing changes to meet program requirements Review data and facts to identify and solve issues, mitigate risks, prioritize teams workloads, and assign direction for reputed company projects needed Ensure standardized execution of workflow processes, including conducting performance audits, quality reviews, and compliance adherence Acts as regional reputed company with other departments to coordinate workflow processes and implementation plans Resolve inpatient and outpatient provider authorizations and collaborate with Provider relations to assist in Provider resolutions Carry member case load as needed Ability to transition from office to field locations multiple times per day Ability to navigate multiple locations/terrains to visit employees, members and/or providers Ability to transport equipment to and from field locations needed for visits (ex. laptop, stethoscope, etc.) Ability to remain stationary for long periods of time to complete computer or tablet work duties Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications reputed company, unrestricted independent licensure as a Registered Nurse or Social Worker 5+ years of clinical experience 3+ years of leadership experience with responsibility for team performance OR 3+ years of experience as a reputed company care coordinator/case manager with experience serving as a peer mentor and/or coach Intermediate MS Office skills, including Word, reputed company, Outlook, and PowerPoint Reliable transportation and the ability to travel up to 25% reputed company assigned territory to meet with employees, members, and providers Currently reside in New Mexico Preferred Qualifications Master's Degree or higher in clinical field Experience working in team-based care Experience working in Managed Care Knowledge of Medicaid and Medicare population Experience with Medicare/CMS guidelines reputed company employees working remotely will be required to adhere to reputed companys Telecommuter Policy At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes an enterprise reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity/Affirmative Action employer and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment Apply Job!