Associate Director Care Management Ohio Medicaid - Remote Ohio

Profile

Description

The Associate Director, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care Management requires a solid understanding of how organization capabilities interrelate across department(s).

Responsibilities

The Associate Director leads and guides others in providing integrated services to and for our customers. Provides ongoing associate coaching and feedback to enhance associate contribution, competency, and performance.


Oversees day to day operations and associates for Ohio Medicaid Care Management.
Achieve performance metrics for a fast paced comprehensive case management environment.
Assure compliance with mandated and corporate policies regarding other departmental areas such as medical management, utilization management and case management.
Develop team members and creates department process flows.
Could lead multiple managers or highly specialized professional associates.
Oversees the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and well-being of members.
Maintain compliance with Ohio Department of Medicaid (ODM), Department of Health and Human Services (DHHS), and the Centers for Medicare and Medicaid Services (CMS) guidelines and contractual requirements.
Decisions are typically related to identifying and resolving complex technical and operational problems within department(s).


Required Qualifications


Unrestricted Registered Nurse (RN) license in the state of Ohio.
Bachelor's Degree in health services, healthcare administration, or business administration.
Minimum five (5) years of previous clinical experience.
Minimum three (3) years of leadership experience.
Proficiency in analyzing and interpreting data trends.
Progressive business consulting and/or operational leadership experience.
Comprehensive knowledge of Microsoft Office applications including, PowerPoint Word, Excel, and Outlook.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
Must reside in the state of Ohio.
This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.
Must have a room in your home designated as a home office; away from high traffic areas where confidential information may be secured.
Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.


Preferred Qualifications


Master's Degree in nursing, public health, health administration, health policy or business.
Knowledge of Humana's internal policies, procedures and systems.
CCM (Certified Care Manager).
Experience with health promotion, coaching and wellness.
Knowledge of community health and social service agencies and additional community resources.


Additional Information


Travel: 25% of the time to Columbus, OH and vicinity.
Direct Reports: Up to 8 Associates.


Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Montage/Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours

40

Company info

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