Supervisor Case Management Remote Delaware

Job Summary

This position manages a team of clinicians who promote quality member outcomes, optimize member benefits, and ensure effective use of resources. The incumbent oversees the development and maintenance of case management processes, including utilization management, strategic planning, care cost initiatives, system development, and quality outcomes. Responsibilities also include hiring, training, coaching, counseling, and evaluating direct reports and ensuring compliance with NCQA, URAC, CMS, DOH, and DOL regulations.

• Manage and coordinate all department activities, including staff education, policy and procedure development, individual staff audits, and overall operations compliance.
• Ensure appropriate workload distribution; monitor and track staff completion of assigned work.
• Develop and implement modifications to workload plans to ensure timely completion and coach/counsel staff.
• Provide service support, training and performance metrics/statistics to the team and initiate process improvements.
• Recruit, select, orient, evaluate, counsel, and develop performance improvement plans; implement promotions, terminations, and career development initiatives per corporate policy.
• Identify and engage executive-level and external stakeholders to resolve issues and ensure alignment with case‑management processes.
• Apply clinical knowledge to coordinate care with facilities and providers, and oversee staff meetings, meeting minutes, and open forums for problem solving.
• Establish targets, measure outcomes, and implement actions to mitigate variances in quality, staff retention, finance, and customer satisfaction.
• Ensure staff meets minimal qualifications through ongoing development, counseling, and disciplinary actions as needed.
• Maintain effective communication with internal and external customers, including change communication, data analysis, and action plan presentation.
• Facilitate informational and educational meetings for internal and external stakeholders.
• Lead special projects and enhanced activities within the department; contribute to departmental project implementation and integration planning.

• High School Diploma or GED.
• Current license in one or more of the following disciplines: LCSW, LSW, LPC, or other related clinical license (OR).
• Current State RN licensure OR Current multi‑state licensure through the eNLC.
• 5–7 years of clinical experience.
• 3–5 years of case‑management/managed‑care experience.
• Preferred data analytics experience and customer‑service orientation.
• Supervisory experience and workforce‑development skills.
• Excellent leadership, collaboration, motivational, and multi‑tasking abilities.
• Strong written and verbal communication skills.
• Data analysis, outcome measurement, and action‑plan development skills.
• Team‑player orientation with strong analytical and organizational skills.
• Prioritization and deadline‑management proficiency.
• Computer and software literacy.

Supervises and manages other employees:
Yes
.

Travel Required:

Yes
Position Type:
Office Based

Employees will comply with HIPAA and data‑security guidelines, and meet all federal, state, and local regulations. The position adheres to ethical and legal standards as set forth in the company’s code of business conduct and policies.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and against all individuals based on any category protected by applicable federal, state, or local law.

Minimum: $86,400.00 – Maximum: $