Job Details

Responsible for leading organization-wide Care Management (CM) initiatives, programs, plans, and policies in accordance with strategic business objectives, professional standards, and applicable regulatory requirements. Accountable for oversight and compliance CM role in the D-SNP Model of Care (MOC), including: Monitoring, oversight, and quality assurance of D-SNP CM reporting and audit universes. Developing and monitoring key process and performance metrics to ensure high-quality, compliant operations and product performance. Enhanced coordination between Medicare and Medicaid with leaders of other clinical programs (e.g. quality, pharmacy, utilization management and transitions of care) to ensure member needs are met. Champion member centered care as a philosophical approach to inform Care Management strategies and programs. Champion motivational interviewing as the foundation of our overall Care Management program. Lead a culture of innovation to advance new CM models and processes...Management, Director, Behavioral Health, Medical Director, Monitoring, Operations, Staffing