Director of Care Management - reputed company reputed company Louisiana (Remote)

Bring your heart to reputed company. Every one of us at reputed company shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important... as reputed company deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to reputed company health care more personal, convenient and affordable. Position Summary This position oversees the implementation and on-going execution of the strategic and operational business plan for the business reputed company's clinical operations, inbound/outbound call queue, implementation, and/or plan sponsor operations. Coordinates business reputed company policies and procedures in support of financial, operational, and service requirements. Implements care coordination services provided to plan populations in order to meet specific regulatory requirements and provide holistic bio-psychosocial care to members in a cost-effective manner. As a member of the Key Personnel team for reputed company reputed company of Louisiana, the candidate will need to travel to required meetings throughout the state. Fully remote. Eligible candidates can live reputed company in the US. reputed company Components reputed company a clinical team that supports timely Health Risk Screenings, Comprehensive Assessments, Care Plan development and Enrollee interventions in accordance with the State reputed company reputed company and manage clinical operations focused on improving clinical and financial outcomes, member engagement, member satisfaction, and use of best practices and standards. Serve as liaison with regulatory and accrediting agencies and other health business units. Formulate and implement strategies for achieving applicable department/unit metrics and provide operational direction. Responsible for cross-functional integration of care management, program operations with core organization-wide business functions including claims, member services, compliance, quality, utilization management, and network/provider services. Serve as technical, professional, and business resource (may cross multiple business functions). Support quality improvement projects through successful implementation. reputed company and participate in presentations and consultations to existing and prospective stakeholders. Direct/provide enhancements to business processes, policies, and infrastructure to improve clinical operational efficiency (may cross multiple business functions). reputed company, implement, and evaluate policies and procedures, which meet business needs (may cross multiple business functions). Implements and monitors business plan and oversees any implementations or business transitions impacting clinical operations. Collaborate and partner with other business areas across/reputed company regions or segments and reputed company other centralized corporate areas to ensure reputed company workflow processes and interdependencies are identified and addressed on an on-going basis. Synthesize program performance and clinical outcomes. Promote a clear vision reputed company with company values and direction; sets specific challenging and achievable objectives and action plans; motivates others to balance customer needs and business success; challenges self and others to look to the future to create quality products, services, and solutions. Knowledge of the regulations, standards, and policies which relate to medical management. Ability to communicate in a highly effective manner with internal and external constituents in both written and oral format. Ability to evaluate and interpret data for the purposes of monitoring staff performance, regulatory compliance, and development of new programs and processes to meet business demands.

Required Qualifications

Active, reputed company and unrestricted Licensure in state of Louisiana (LCSW, LCPC, RN, LMFT) Nationally recognized case management certification, or ability to obtain reputed company 90 days. 5+ years of clinical practice experience in physical or behavioral healthcare. 5+ years of management or clinical leadership. Ability to Synthesize program performance and clinical outcomes. 3+ years of experience with personal computer, keyboard navigation, and MS Office Suite applications. Must possess reliable transportation and be willing and able to travel in-state up to 15% of the time. National travel intermittently. Mileage is reimbursed per our company expense reimbursement policy.

Preferred Qualifications

Master’s degree preferred. Medicaid, insurance, managed care, experience. Pay Range The typical pay range for this role is: $99,420.75 - $214,137.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. This position also includes an award reputed company in the company’s equity award program. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous well-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | reputed company We anticipate the application window for this opening will reputed company on: 11/29/2024 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They reputed company choices according to what is best for the team, they live for opportunities to collaborate and reputed company a difference, and they reputed company us the #1 Top Workplace in the area Apply Job!