Manager, Case Management
Location: Bedford New Hampshire
Description: Centene is currently seeking to employ Manager, Case Management right now, this vacancy will be placed in New Hampshire. Detailed specification about this vacancy opportunity please give attention to these descriptions. Centene Corporation is a leading multi-line healthcare enterprise that provides managed-care programs and related services to individuals receiving benefits under Medicaid,! including Supplemental 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 agreem! ents. * Develop, implement and maintain compliance with polici! es 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. 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 vacancy, please email us your resume, with salary requirements and a resume to Centene.
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This vacancy starts available on: Sat, 27 Apr 2013 09:46:13 GMT