Manager, Care Management Transition of Care Team - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)
Core
Lead a team of nurse care managers to coordinate seamless transitions of members from acute care settings to home or post-acute care, reducing readmissions and improving outcomes.
Role type
Manager, Care Management Transition of Care Team
Builds
Coordinated care pathways for high-risk members transitioning from hospitals to community settings
Domain
Healthcare / Managed Care Administration
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Team leadership and mentorship, Clinical data analysis, Process improvement (PDSA, root-cause analysis), Regulatory compliance (CMS), Stakeholder engagement with hospital systems, KPI monitoring
Preferred skills
Nursing administration certification, Ambulatory care certification, Case management certification
Technologies
EHRs, Care management software systems
Responsibilities
Delegate caseloads and supervise nurse care managers, Analyze clinical data to identify gaps and cost drivers, Partner with hospital systems and ACOs to establish communication pathways, Oversee proactive identification of high-risk members and implement mitigation strategies, Ensure timely post-discharge follow-up and program enrollment, Monitor and report key metrics including 30-day readmission rates
Seniority
Manager, hands-on leadership