Manager of Care Management

## Manager of Care Management Apply:
Remote:
US Remote:
Providence, RI:
Full time:
Posted Today:
JR100460
** Pay Range:**$93,600.00 - $Please email
** HR _Talent _Acquisition Team
** if you are a candidate seeking a reasonable accommodation for the application and/or interview process.
** At BCBSRI, our greatest resource is our people.
** We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well.
** We recognize that to do your best work, you have to be your best self.
** It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.
** Our culture is one of belonging.
** We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued.
** Join others who value a workplace for all.
** We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders.
** We’re dedicated to serving Rhode Islanders.
** Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.
** Must reside within a commutable distance (RI,MA,CT).*
* ** Why this job matters:
** Manage daily operations of department. Manage the development, implementation, and maintenance of departmental policies, procedures and programs. Ensure the delivery of case management services are aligned with industry standards, best practices, and the company’s strategy. Monitor industry trends to ensure case management programs are innovative and designed to meet the company’s goals.

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* What you will do:

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* * Manage case management programs to ensure the delivery of services is aligned with the company’s goals.
* Develop programs to ensure collaboration between utilization and case management are maximized to achieve departmental objectives.
* Conduct evaluations of programs to determine effectiveness of programs and need to modify or eliminate.
* Make recommendations for improvements of case management programs to the department’s leadership team.
* Monitor department expenses on a regular basis to ensure budget targets are achieved.
* Ensure department complies with all applicable regulatory guidelines including NCQA, DOH, CMS, URAC, HIPAA, State of RI Workers Comp Protocol. DOL.
* Assist with contract development and implementation to ensure contracts reflect medical management initiatives, processes, and regulatory requirements.
* Provide direction and guidance to staff.  Set goals, review and evaluate work,…