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 continuum of care for high-risk members transitioning from hospitals to home/outpatient care
Domain
Healthcare / Managed Care Administration
Required skills
Team leadership and mentorship, Clinical data analysis, Process improvement, Regulatory compliance (CMS), Stakeholder engagement, Quality assurance
Preferred skills
Nursing administration certification, Ambulatory care certification, Case management certification
Technologies
EHR systems, Care management software
Responsibilities
Delegate caseloads and supervise KPIs for nurse care managers, Partner with hospital systems and ACOs to establish communication pathways, Oversee proactive identification of high-risk members and implement mitigation strategies, Monitor and report key metrics including 30-day readmission rates, Ensure compliance with CMS requirements and MAC guidelines, Build strategic relationships with discharge planners and post-acute care facilities
Seniority
Manager, hands-on leadership