Manager I Care Management
Core
Manage a team of clinicians to promote quality member outcomes, optimize member benefits, and ensure effective use of resources in a clinical pharmacy setting.
Role type
Manager I Care Management (Licensed Nurse)
Builds
Total life care programs for patients and families
Domain
Healthcare / Clinical Pharmacy / Care Management
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Acute care clinical experience, Medical necessity assessment, Process improvement, Quality assurance, Budget management, Team leadership, Policy implementation
Preferred skills
Case management certification, Bilingual proficiency (English/Spanish), Strategic planning, Health services education
Technologies
None stated
Responsibilities
Assess medical necessity of outpatient and out-of-network services; oversee process improvement and quality assurance; ensure accreditation standards; establish strategic plans and policies; manage annual budget productivity targets; hire, train, and evaluate direct reports
Seniority
Manager, hands-on IC
