Manager, Care Management

This is a fully remote position, open to applicants in Ohio.

📋 Description

• Oversee the care management team and coordinate care for behavioral health members.

• Develop and evaluate high-quality, cost-effective healthcare outcomes concerning mental and behavioral health needs.

• Handle escalations and care management issues involving members or providers.

• Review and supervise necessary care management documentation to ensure regulatory and contractual compliance.

• Create, implement, and manage care management policies, procedures, and programs.

• Direct the daily operations of the care management staff, including the review and approval of caseloads.

• Address escalated and complex care cases while guiding team members.

• Resolve complaints and assist with audits and evaluations.

• Establish goals and objectives for the care management team.

• Provide updates and insights to senior management.

• Offer feedback to enhance member and provider experiences and the quality of care.

• Educate and supply resources to the care management team regarding key initiatives and member outreach.

• Assist with the onboarding, hiring, and training of care management staff.

⛳️ Requirements

• Must be a resident of Ohio.

• An active clinical license in Ohio is required.

• A Master's degree or graduation from an Accredited School of Nursing is necessary.

• At least 5 years of relevant experience is required.

• Licensed Clinical Behavioral Health Professional or RN is needed per state contract requirements, e.g., LCSW, LMSW, LMFT, LMHC, and RN with behavioral health experience.

• Proven leadership experience is essential.

• A background in behavioral health, managed care, case management, or community mental health centers, along with utilization review.

• Exceptional communication and presentation skills are required.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K and stock purchase plans.

• Tuition reimbursement opportunities.

• Paid time off plus holidays.

• A flexible work approach, offering remote, hybrid, field, or office schedules.

• Additional incentives may be included in the total compensation package.