Manager, MBB

*** Must have minimum 3 years of maternity experience***

Job Summary:

The Manager, Care Management provides operational management and oversight for providing CareSource members with the right care at the right place at the right time and assisting them to achieve optimal clinical, financial, and quality of life outcomes.

Essential Functions:

• Oversee a team of clinical and nonclinical staff to achieve quality service level and production expectations
• Facilitate/promote problem identification, analysis and resolution to improve member experience, ensuring compliance with state and federal regulatory and accrediting standards and implementation of the Care Model.
• Manages and evaluates team member performance; provides coaching, counseling, employee development, and recognition; ensures ongoing, appropriate staff training; and has responsibility for the selection, orientation and mentoring of new staff.
• Ensures adequate staffing and service levels and maintains customer satisfaction by implementing and monitoring staff productivity and other performance indicators.
• Ensures completion of staff quality audit reviews. Evaluates services provided and outcomes achieved and recommends enhancements/improvements for programs and staff development to ensure consistent cost effectiveness and compliance with all state and federal regulations and guidelines
• Maintains professional relationships with provider community, internal and external customers, and state agencies as appropriate, while identifying opportunities for improvement.
• Utilize available tools / platforms for efficiencies
• Understand the mission and ensure alignment of compliance-based activity in strategic planning / department goal-setting and regional market support
• Assist in new market development and implementation of department initiatives
• Perform any other job duties as requested

Education and Experience:

• Bachelor’s degree or equivalent years of relevant work experience is required
• A minimum of five (5) years of managed healthcare experience is required
• A minimum of two (2) years of supervisory experience is required
• Managed care experience is preferred

Competencies, Knowledge and Skills:

• Display a customer service, member-focused orientation
• Strong team and staff development skills
• Strong collaboration and conflict resolution skill sets
• Ability to develop, prioritize and accomplish goals/time management
• Strong decision making and problem-solving skills
• Exceptional communication skills (both written and verbal) with the ability to present information in a variety of different formats to all levels
• Strong ability to teach best practice, engagement strategies for successful member participation (including motivational interviewing, best practice engagement techniques)
• Ability to work in a fast-past environment
• Ability to work independently and within a team environment
• Advanced knowledge of Microsoft Word, Excel, PowerPoint and Visio

Licensure and Certification:

• Active, unrestricted State Licensed Practical Nurse (LPN), Registered Nurse (RN) license, Social Work license, or Counselor license is preferred
• Healthcare or Management certification is preferred
• To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
• CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Ability to travel as required by the needs of the business

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Create an Inclusive Environment

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.