Manager, Care Management
Requisition #: 292585
Location: Johns Hopkins Health Care, Hanover, MD 21076
Category: Non-Clinical Professional
Work Shift: Day Shift
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: Dec. 1, 2020
Johns Hopkins HealthCare (JHHC) is the managed care and health services business of Johns Hopkins Medicine, one of the premier health delivery, academic, and research institutions in the United States. JHHC is a $2.5B business serving over 400,000 lives with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHC has become a leader in provider-sponsored health plans and is poised for future growth.
Many organizations talk about transforming the future of healthcare, Johns Hopkins HealthCare is actually doing it. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for the members and communities we serve. If you are interested in improving how healthcare is delivered, join the JHHC team.
Responsible for delivery of case and disease management services to designated populations. Responsible for managing the daily activities and outcomes of exempt and non-exempt employees. The Program Manager will work with the Director on ensuring adequate staffing and training to meet clinical and program needs. Responsible for measuring staff performance based upon JHHC policy and procedures and accreditation standards. Additionally, the Program Manager will be responsible for managing strategic relationships with client groups and community leaders as needed.
TASK REQUIREMENTS FOR POSITION:
Works with area-specific management to develop new programs and systems that will enhance the systems of area-specific operations. Analyzes area-specific data to identify trends and opportunities to improve care and/or service delivery
Active partner in day-to-day operations of Care Management and development of new initiatives.
Implements and facilitates disease or utilization-specific databases and processes.
Assures program components are up to date.
Maintains professional competency and future development by attending continuing education conferences and seminars.
Care Management - Bachelor’s degree in Nursing or related field, or a Master’s degree in Social Work required. Master’s degree in Nursing, or related health care field preferred.
Knowledge of health care and managed care delivery systems. This includes standards of medical practice; insurance benefit structures and related legal/ medical issues; and utilization management and quality improvement processes.
Work requires a high level of interpersonal skills to effectively interact and affect change with all levels of staff and outside business related associates.
Work requires the ability to work independently, to assess situations and respond appropriately, and the ability to initiate and implement policy and procedures. Must be willing to accept change.
Work requires excellent communication and writing skills. Work requires the ability to facilitate and promote public relations to the community and civic groups in addition to excellent communication skills with all levels of staff and outside business related associates.
Work requires a high level of interpersonal skills and attitude to effectively project a positive image of managed care programs by being professional, courteous, helpful and friendly in relationships with all levels of staff and external business related associates.
D. Required Licensure, Certification, Etc.:
Current RN or LCSW-C licensure in the state of Maryland or in a compact State required.
Certification in Case Management (CCM) preferred
E. Work Experience:
Minimum of eight years clinical experience, which includes a minimum of three years in a managed care environment (case management or utilization management).
Minimum two years management experience, preferably in the managed care environment.
F. Machines, Tools, Equipment:
Must be able to operate computer, general office and communication equipment.
A. Budget Responsibility:
Effectively uses resources within control. Monitor department/cost center budget.
B. Authority/Decision Making Level:
Makes decision about staffing and office requests. Makes decisions regarding work processes based on established guidelines. Prioritizes the workload of the case management staff. Develops reports and documentation materials. Works independently with limited supervision.
C. Supervisory Responsibility:
Manages care management staff: has the responsibility for hiring, firing, performance management and results of the area. Responsible for overall departmental training. Provides guidance and direction to other departmental management and staff. Responsible for adequate coverage of case management area.
Perform critical thinking as it relates to care management activities. Utilizes defined policies and procedures to ensure consistent application of care management criteria.
Must be able to perform data entry and understand patient data reports, utilization reports and measure and assess outcomes.
Works in office environment.
Work is sedentary in nature, however, some standing, stooping, bending and walking is requires. The position requires keyboard activity, pulling, filing, and duplicating.
Requires local travel to off-site meetings.
Johns Hopkins Health System and its affiliates are Equal Opportunity/Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, sex, age, national origin, disability, protected veteran status, and or any other status protected by federal, state, or local law.
Johns Hopkins Medicine.