Clinical Manager, Care Management Services (Remote)We are seeking a dynamic and experienced Clinical Manager of Care Management Services to oversee,coordinate, and deliver comprehensive care management services across both behavioral health and medical care settings. This clinical leadership role is critical in ensuring the seamless delivery of integrated care, optimizing patient outcomes, and promoting the efficient and effective utilization of resources within our organization. This Clinical Manager is expected to split his or her time between administrative / managerial responsibilities (typically ~60% of the time) and time serving patients directly (typically ~40% of the time).
WHAT IS YOUR SUPERPOWER?
Administrative & Managerial Responsibilities
- Develop, implement, and oversee care management policies, procedures, and protocols for behavioral health and medical care.
- Lead and supervise a multidisciplinary Care Management team organized in a "pod" model where:
- Care Managers (Registered Nurses and Behavioral Health Care Managers) are responsible for comprehensive care planning and clinical coordination,
- Licensed Practical Nurses (LPNs) focus on post-discharge outreach, coordination, and Transitional Care Management (TCM), while
- Patient Resource Specialists (PRSs) support our patients by addressing health-related social needs and social determinants of health.
- Manage care coordination processes across multiple payor environments, ensuring consistent standards of care, regulatory alignment, and effective operational workflows.
- Ensure compliance with regulatory requirements related to care management and patient care.
- Support the design and implementation of strategic initiatives that enable Author Health to innovate by piloting modifications or new builds in our care delivery model.
- Participate in interdisciplinary meetings and committees to enhance coordination and communication across departments.
- Coach members of the Care Management team to enhance performance on both clinical quality and overall efficiency - do so while using a data-driven approach, and by regularly shadowing and auditing individual team members (e.g., auditing calls and documentation).
- Monitor and analyze data related to care management outcomes, utilization, and quality improvement initiatives.
- Promote a culture of excellence, professionalism, and continuous improvement within the Care Management team.
- Perform other duties as assigned to support departmental and organizational needs.
Patient Care Delivery Responsibilities
- Conduct regular assessments of patient needs, develop individualized care plans, and monitor progress towards goals.
- Coordinate transitions of care and ensure continuity across different levels of care and health care settings.
- Collaborate closely with interdisciplinary teams of health care providers both within and outside of Author Health, including physicians, nurses, therapists, and social workers, to ensure integrated care planning and delivery.
- Serve as a resource for staff, patients, and families regarding care management services, resources, and community referrals.
WHAT WE ARE SEEKING:
- Bachelor's degree in Nursing; Master's degree preferred.
- Experience building and leading teams
- Minimum of 5 years of Nursing experience in care management, preferably in behavioral health or medical care settings.
- Proven leadership and supervisory experience with strong team-building skills.
- Excellent interpersonal and communication skills, with the ability to collaborate effectively with diverse stakeholders.
- Solid understanding of health care regulations, policies, and reimbursement practices.
- Strong analytical skills and the ability to use data for decision-making and quality improvement.
- Certification in Case Management (CCM, ACM, or similar) preferred
WHAT WE OFFER:
- Retirement savings plan (401k) Plan up to 3.5% company match
- Low cost benefits package for employee and dependents ( medical/ dental/ vision/ STD/ Life Insurance)
- Paid vacation
- Paid sick leave
- 9 paid holidays throughout the year with (2) additional flex holidays .. 11 in total!
- Performance-based bonuses
- and more!
NEXT STEPS:
- Submit an application
- Upload an updated resume
- Share LinkedIn profile and/or cover letter
Monday through Friday, 8am-5pm EST
