Licensed Manager of Care Management

Aetna   •  

Sacramento, CA

Industry: Managed Care & Health Insurance


5 - 7 years

Posted 381 days ago

The Manager, Care Management provides oversight and management of clinical team processes including the organization and development of high performing teams.

Fundamental Components:
Reinforces clinical philosophy, programs, policies and procedures. Communicates strategic plan and specific tactics to meet plan. Ensures implementation of tactics to meet strategic direction for cost and quality outcomes. Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results. Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes. Accountable for meeting the financial, operational and quality objectives of the unit. May be accountable for the day-to-day management of teams for appropriate implementation and adherence with established practices, policies and procedures if there is not supervisor position Works closely with functional area managers to ensure consistency in clinical interventions supporting our plan sponsors. Develop, initiate, monitor and communicate performance expectations. May act as a single point of contact for the customer and the Account Team which includes participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers. Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills. Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams. Consistently demonstrates the ability to serve as a model change agent and lead change efforts. Accountable for maintaining compliance with policies and procedures and implements them at the employee level. Ability to evaluate and interpret data, identify areas of improvement, and focuses on interventions to improve outcomes.


  • 5-7 years in clinical area of expertise; Required
  •  Master's degree in behavioral health field; OR Registered Nurse (BSN preferred): and Active unrestricted State Licensure in applicable functional area. (eg RN, LPC, LCSW); Required
  • Leadership and Supervisory Experience; Strongly Preferred
  • Experience working in Long Term Support Services; Strongly Preferred
  • Experience working for an HMO or Managed Care Organization; Strongly Preferred

The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

One of these 3 licenses is required.

Nursing/Registered Nurse is desired
Mental Health/Licensed Clinical Social Worker is desired
Mental Health/Licensed Professional Counselor is desired

Functional - Administration / Operations/Management: < 25 employees/1-3 Years
Functional - Medical Management/Medical Management - Case Management/4-6 Years
Functional - Medical Management/Medical Management - Managed Care/Insurance Clinical Staff/4-6 Years

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