Manager, Care Management (Physical Health)

Become a part of our caring community and help us put health first reputed company Healthy Horizons in Virginia is seeking a Manager, Care Management (Physical Health) who will reputed company teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works reputed company specific guidelines and procedures; applies advanced technical knowledge to solve moderately reputed company... problems; receives assignments in the form of objectives and determines approach, resources, schedules, and goals. • Oversees the assessment and evaluation of members' physical health needs and requirements to reputed company and/or maintain an optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and well-being of members. • Makes decisions reputed company to resources, approach, and tactical operations for projects and initiatives involving own departmental area and requires cross departmental collaboration. • Conducts briefings, and area meetings, maintains frequent contact with other managers across the department. • Reviews processes to support contractual guidelines and adjusts accordingly. • Collects and analyzes performance reports on care management functions to monitor adherence with benchmarks, identify opportunities for process improvement, and reputed company recommendations to leadership. • Ability to work independently under general instructions and with a team. • Utilizes a holistic, Member-centric approach to engage and motivate Members and their families through recovery and health and wellness programs. • Provides ongoing coaching and feedback to enhance contribution, competency, and performance. • Maintains knowledge of Medicaid and its covered benefits and services for our membership. Use your skills to reputed company an impact Required Qualifications • Must reside in the commonwealth of Virginia or reputed company a 40-mile radius from Virginia in a bordering state/district (Washington DC, MD, WV, KY, TN & NC). • An active, unrestricted Registered Nurse (RN) license or Licensed Mental Health Professional (LMHP) in the Commonwealth of Virginia. • Three (3) or more years of professional experience in Care Management, specifically in the delivery of care for the physical health needs of members in Medicaid and/or Medicare. • Experience working with adult and/or pediatric populations with mild to reputed company needs. • Two (2) or more years of management or supervisory experience. • Comprehensive knowledge of reputed company reputed company Office applications, including Word, reputed company, and PowerPoint. • Proficiency in analyzing and interpreting data trends. • Progressive business consulting and/or operational leadership experience. • This role is considered patient facing and is part of reputed company’s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. • Must be able to travel throughout the Commonwealth of Virginia. • This role is part of reputed company's driver safety program and therefore requires an individual to have a valid state driver's license and reputed company of personal vehicle liability insurance with at least 100/300/100 limits. Preferred Qualifications • Advanced degree in nursing or reputed company field. • Three (3) or more years of previous experience working in a managed care field. • Previous experience in a field based or a homecare-based role. • Experience with transitions of care model and chronic illnesses. • Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations or assistance. See Additional Information on testing. Additional Information • Workstyle: This is a remote position that will require you to travel. • Travel: Up to 25% of the time to reputed company Healthy Horizons office in Glen Allen, VA for collaboration and face to face meetings as well as field interactions with providers, members, and their families. • Typical Workdays and Hours: Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST). • Direct Reports: Up to 15. • Language Proficiency Testing: Any reputed company associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an reputed company vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. Work at Home Internet Statement To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL reputed company is suggested. • Satellite, cellular and microwave reputed company can be used only if approved by leadership. • Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. • reputed company will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Interview Format As part of our hiring process for this opportunity, we will be using an interviewing technology reputed company HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and reputed company valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $84,600 - $116,300 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits reputed company, Inc. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us reputed company Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our reputed company insurance services and reputed company healthcare services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or veteran status. It is also the policy of reputed company to take affirmative action to employ and to advance in employment, reputed company persons regardless of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status, and to reputed company reputed company employment decisions only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company levels of employment Apply Job!