Manager, Case Management
Location: Bedford New Hampshire
Description: Centene is currently interviewing Manager, Case Management right now, this job will be placed in New Hampshire. For complete informations about this job opportunity please read the description below. Centene Corporation is a leading multi-line healthcare enterprise that provides managed-care programs and related services to individuals receiving benefits under Medicaid, including Supplemen! tal Security Income (SSI) and the State Children's Health Insurance Program (SCHIP).Position Purpose: Perform duties to conduct and manage the day-to-day operations of the case management functions communicating with departmental and plan administrative staff to facilitate daily department functions.Knowledge/Experience: Bachelor's degree in nursing or equivalent experience. 3 - 5 years case management experience and 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.Position Responsibilities: * 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, imp! lement and maintain compliance with policies and procedures re! garding 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. Licenses/Certifications: Current registered nurse in applicable state(s) and state driver's license and automobile insurance. Case Management Certification (CCM) preferred.
3 or more years of experience
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If you were eligible to this job, please email us your resume, with salary requirements and a resume to Centene.
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This job starts available on: Wed, 27 Mar 2013 10:03:47 GMT