Associate Director Case Mgmt. UHC - Community Plan

8 - 10 years experience  •  Insurance

Salary depends on experience
Posted on 10/25/17
Omaha, NE
8 - 10 years experience
Insurance
Salary depends on experience
Posted on 10/25/17

Position Description

Primary Responsibilities:

  • Implementation and oversight of all clinical management functions for individuals receiving care management (level one and two) program, including but not limited to: assessment, care coordination, interaction with state agencies and community organizations as related to care plan coordination, participant and caregiver education, and oversight of multi-disciplinary care conferences
  • Implementation and oversight of all program management functions, including but not limited to: compliance with program requirements, rules and regulations, implementation of and management of program policies, procedures and protocols that are aligned with federal and state requirements, with an emphasis on audit readiness
  • Participation in all audit reviews both internally and with external partners
  • Successful candidate may represent the plan at meetings with stakeholders, members and regulators, as requested by leadership
  • Candidate should be comfortable with and have experience with public speaking and conducting meetings
  • Superior Excel and PowerPoint skills
  • Experience working with diverse groups of members, state/federal regulators, and stakeholders
  • Candidate should be a patient advocate, and have tenacity for finding solutions
  • Extensive knowledge of the continuum of care

Required Qualifications:

  • Nebraska Registered Licensed Nurse
  • Must be a Nebraska resident
  • 8+ years of clinical experience in health care clinical settings
  • 5 years of extensive experience in leadership and management  
  • Experience managing professional remote personnel
  • At least 5 years of experience in case management, LTSS, TCM IDD or Behavior Health populations

Preferred Qualifications:

  • Certified in case management
  • Master’s degree in health related field
  • Previously worked in a managed care sector

721853

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