Mgr-Care Management Optimization; Remote

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Showing 1 location

Home Office
Morrisville, NC 27560, USA

• Remote
• Care Management
• Full-Time
• Requisition #: MGRCA
  003630

The Manager - Care Management Performance Optimization is responsible for driving operational alignment and leading performance and optimization initiatives across the Care Management department. The role focuses on identifying performance gaps, streamlining processes, enhancing service delivery, and executing cross-functional projects to improve quality, cost-efficiency, and member satisfaction.

This position is full-time remote. Selected candidate must reside in North Carolina and be willing to travel to the home office (Morrisville, NC) for onsite team meetings as needed

Responsibilities & Duties

Performance Management

• Monitor, analyze, and report on care management KPIs
• Collaborate with care management leadership and others to develop performance dashboards and reporting tools
• Identify performance gaps and lead root cause analysis and action planning
• Improve care management business processes by enhancing operational efficiencies
• Develop and maintain standardized care management workflows and documentation practices

Optimization

• Support CM leadership with projects targeted to address care management high priority operations
• Implement Lean Six Sigma, or similar process improvement models/methodologies to reduce costs, improve quality and enhance member experience
• Manage initiatives/work streams that streamline workflows, reduce administrative burden and improve member outcomes
• Support change management initiatives and CM specific operational projects to ensure effective adoption of new processes or technologies

Operational Excellence and Compliance

• Act as the liaison within Care Management department and between cross-functional areas to drive process improvement initiatives aligned with the organization’s business goals and targets
• Lead and/or participate in interdisciplinary committee or work groups as determined by leadership
• Ensure high standards of care and support services are delivered in compliance with regulatory, contractual and legal requirements and obligations
• Contribute to long-term care management strategy through data insights and performance trends

Stakeholder Collaboration and Communication

• Facilitate collaboration between internal and external stakeholders to identify strategic partnerships for the success of program initiatives and requirements
• Generate and present reports, dashboards and ad-hoc analyses to communicate performance, findings and recommendations to leadership and other stakeholders
• Serve as a subject matter expert on care management operations and best practices
• Collaborate with leadership to align operational goals with overall strategic objectives
• Other duties as assigned

Manage and Develop Staff

• Work with Human Resources to attract, maintain, and retain a highly qualified and well-trained workforce
• Ensure staff are well trained in and comply with all organization, department, and oversight agency policies, procedures, and business processes
• Organize workflows and ensure staff understand their roles and responsibilities
• Ensure the department has the needed tools and resources to achieve organizational goals and to support employees and ensure compliance with licensure, regulatory, and accreditation requirements
• Actively establish and promote a positive, diverse, and inclusive working environment that builds trust
• Ensure all staff are treated with respect and dignity
• Ensure standards are transparent and applied consistently, impartially, and ethically over time and across all staff members
• Work to resolve conflicts and disputes, ensuring that all participants are given a voice
• Set goals for performance and deadlines in line with organization goals and vision
• Effectively communicate feedback and provide ongoing coaching and mentoring to staff and support a learning environment to advance team skills and professional development
• Cultivate and encourage efforts to expand cross-team collaboration and partnership

Education & Experience

Required :

Bachelor’s degree in Nursing, Healthcare Administration, Human Services, Public Health, Business…