Works to enhance the quality of patient management and satisfaction and promotes continuity of care and cost effectiveness through integration of the functions of case management, utilization review/management and discharge planning.
In this role, the selected candidate will be overseeing population management activities with the Care Coordinators which includes addressing quality indicators that are out of range and assisting patients to reach targets.
In this role, you will be responsible to review and oversee the assessment and care plan for clinical appropriateness, appropriate service referral/utilization and integration across all health domains.
This position is responsible for working with foster and biological families in their home communities by offering comprehensive case management services. The goal of the position is to implement services for the long-term, leading to positive outcomes for the youth and families served.
The Care Manager is responsible for core services of health home care management including comprehensive care management, care coordination and health promotion, comprehensive transitional care, youth and family support and referral services while using technology to link services.
In this role, the selected candidate will strategically manage a sales pipeline to create sales growth and maximize revenue opportunities. Routinely analyze pipeline coverage percentage and target, hit rate, and pipeline deal profile to ensure that pipeline supports achievement of monthly, quarterly and annual goals.
The Care Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit design and/or acute and chronic health needs through communication and available resources to promote optimal, cost-effective outcomes.
In this role, the selected candidate conducts reviews for medical necessity of psychiatric/substance abuse cases utilizing professional knowledge while applying Beacon Health Options criteria consistently and render certification decisions that are within the scope of practice that is relevant to the clinical areas under review.