Manager, Case Management

Location: Appleton/Milw/EauClaire, WI
Job Type: Direct Hire
Degree: Bachelor;
Date: 11/1/2017
Job ID: 02523534
Job Description

Manager, Case Management – Milwaukee or Eau Claire, OR APPLETON, WI - CHOOSE a location!

Serve as the leader for this health plan's newly established satellite office.  Lead the daily operations of case management function. Reporting to a Sr Director in the main office, Manager will have responsibility for maintaining effective communication. 

Review analyzes of activities, costs, operations and forecast data to determine progress toward stated goals and statistical/financial purposes.

Promote compliance with federal and state regulations and contractual agreements.

Develop, implement and maintain compliance with policies and procedures regarding medical case management.

Develop, implement, and maintain case management programs to facilitate the use of appropriate medical resources and decrease health plan financial exposure.

Facilitate on-going communication between case management staff, members, contracted providers, and subsidiaries.

Develop staff skills and competencies through training and experience.

Qualifications:
- Bachelor’s degree in Nursing or equivalent experience.
- 3+ years case management experience
- Recent nursing experience in an acute care setting particularly in medical/surgical, pediatrics, or obstetrics and management experience.
- Thorough knowledge of case and/or utilization management and clinical nursing.
- Familiarity with Medicaid managed care practices and policies, CHIP, and SCHIP.
-Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.

License/Certification: Unrestricted RN license in WI &  valid driver's license

Preferred:
CCM Certification