Job Description

Title: Manager of Case Management

Location: Chatsworth, CA 91311

Schedule: Full-time, Monday - Friday, 8:00 AM - 5:00 PM

Compensation: $50.00 - $55.29 per hour

We are seeking an experienced and dedicated Manager of Case Management to lead our Case Management Department. This role is crucial in ensuring the efficient and compliant delivery of care to our Medicare Medi-Medi population. We are a reputable Independent Physician Association (IPA) known for our strong leadership, collaborative environment, and commitment to employee well-being. If you are a hardworking and accountable leader ready to make a significant impact, we encourage you to apply.

While this position is primarily on-site , a hybrid work arrangement (e.g., 3 days on-site, 2 days remote) may be possible after an initial training period. However, a 4/1 or 5/0 on-site schedule is preferred. The first 6-8 weeks of training will require full on-site presence.

Responsibilities

The Manager of Case Management is responsible for the overall management and operations of the Case Management Department, including:

• Department Leadership & Oversight:
• Manage the Case Management Department, ensuring adherence to established policies and procedures.
• Monitor case assignments and ensure the timely completion of Individualized Care Plans (ICPs) and Interdisciplinary Care Team (ICT) meetings.
• Complete and submit all required department reports and participate in all internal and external audits.
• Participate in the recruitment and training of new personnel.
• Provide administrative support as assigned.
• Daily Operations:
• Run master logs for daily staff assignments.
• Ensure Registered Nurses (RNs) sign off on all completed care plans from the previous day.
• Assign completed care plans to Case Management Coordinators for distribution.
• Recurring Tasks:
• Bi-weekly: Process department payroll.
• Monthly: Prepare and submit health plan monthly reports, attend health plan monthly meetings, conduct team meetings, and perform internal department self-audits.
• Quarterly: Prepare and submit health plan quarterly reports.
• Annually: Complete staff performance reviews.
• As Needed:
• Attend health plan webinars and audits.
• Maintain departmental tutorials, policies, and procedures.
• Participate in the development of new policies and procedures and strategic planning initiatives.
• Provide coverage for the completion of ICPs and ICTs when nurses are out, including:
• Reviewing patient history, medical records, health risk assessments, and previous care plans.
• Contacting members to discuss healthcare needs and assist with care plan development.
• Developing and updating Individualized Care Plans (ICPs) as patient conditions change or during transitions of care.
• Participating in Interdisciplinary Care Team (ICT) meetings with members, social workers, PCPs, health plans, and other care providers.
• Engage in other activities that support the Case Management Department.

Qualifications

• Education & Experience:
• Current, active California Registered Nurse (RN) license required.
• Minimum of 5 years of Case Management experience, with Managed Care experience strongly preferred.
• Minimum of 2 years of Management experience.
• 2-5 years of experience in a Managed Care setting.
• Experience with Medicare member case management is a plus.
• Skills:
• Attendance & Dependability: Must maintain excellent attendance and punctuality, be prepared, and able to meet deadlines.
• Attention to Detail: Strong organizational skills with the ability to pay close attention to all details.
• Business Acumen: Professional appearance and ability to display a professional and positive approach to the job.
• Adaptability/Flexibility: Embraces and readily adapts to changing business needs, including accepting changing job requirements, learning new skills, and applying newly acquired skills.
• Communication: Ability to communicate thoughts and ideas effectively and tactfully in both oral and written form. Listens and communicates effectively with customers through expression of interest, empathy, voice quality, courtesy, and written composition. Responds in a manner that shows an accurate understanding of customer requirements and corporate objectives.
• Interpersonal/Participatory Skills: Works effectively with individuals and teams, building constructive relationships and maintaining the self-confidence and self-esteem of others. Must be a team player.
• Ownership/Dependability: Assumes responsibility for accomplishing goals and objectives by accepting ownership of assignments, adhering to established work schedules, practicing efficient time management to meet quality service goals, and supporting team objectives. Willingness to be held accountable for errors.
• Judgment/Decision Making: Exercises sound judgment and decision-making by demonstrating the ability to interpret policies and procedures and evaluate alternative courses of action in a positive approach.
• Customer Satisfaction: Identifies customer needs to exceed expectations by working outside set procedures when appropriate and following through on customer issues. Assures complete resolution of customer concerns and builds customer confidence while supporting the IPA’s business philosophy.

Technical Requirements for Remote Work

For potential remote work, candidates must provide their own equipment meeting the following specifications:

• Operating System: Windows 10 or higher.
• RAM: Minimum of 8GB.
• Internet Speed:
• Download: 20 Mbps or faster.
• Upload: 8 Mbps or faster.
• Monitors: While a single monitor can be used, productivity is significantly enhanced with dual screens. Our office provides dual screens for all UM roles, and training and production measurements are based on this setup. Candidates working remotely will need to adjust accordingly.

Why Join Our Team?

Be part of a thriving and supportive environment where senior leadership has a long tenure and a strong reputation within the market. We are committed to maintaining our standing as one of the "good" IPAs by fostering a collaborative culture and investing in our employees. We offer solid benefits programs, competitive pay packages, and generous Paid Time Off (PTO) to support our team members.

Preferred (But Not Required)

• Spanish Speaking: Given our high population of Spanish-speaking members, proficiency in Spanish is preferred to enhance productivity and reduce communication delays. However, all qualified candidates are encouraged to apply.

If you are a driven and compassionate Case Management leader looking for a rewarding opportunity, we invite you to apply!

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