California Licensed Care Management Manager

Job Summary

Managing the daily operations of inpatient and care management staff, the full-time California Licensed Care Management Manager will oversee concurrent and retrospective inpatient reviews, discharge planning, and transitional care programs while ensuring compliance with federal, state, and health plan requirements in a remote setting.

Key responsibilities

• Oversee the management of inpatient and care management staff to ensure effective workflow and resource utilization
• Develop and implement policies and procedures to enhance department performance and customer satisfaction
• Monitor department performance against compliance requirements and serve as a resource for staff on complex issues

Required qualifications

• Current RN license in the State of California
• BSN or Bachelor's Degree in a healthcare-related field
• Minimum of 2 years of supervisory experience in a medical group or health plan setting
• At least 2 years of experience in Inpatient Case Management and/or Outpatient Care Management
• Understanding of nationally recognized criteria such as Milliman Care Guidelines, Interqual, or CMS