Manager Clinical Care Coordination (remote)

Highmark Health

Base: $94,200.00 - $151,000.00; bonus/equity: not ...
5 years clinical or utilization management experience
3 years management or leadership role
Current pa rn licensure or social work license
The incumbent is responsible for the leadership and performance management of supervisory staff within a combined case management and utilization management team

Job Summary

  • The incumbent is responsible for the leadership and performance management of supervisory staff within a combined case management and utilization management team.
  • This role involves developing longer-term plans to improve utilization, quality, and clinical outcomes based on market trends and legislative environments.
  • The position requires ensuring overall compliance with business process requirements, regulatory standards, and accreditation guidelines across all lines of business.

Matching Summary

The incumbent is responsible for the leadership and performance management of supervisory staff within a combined case management and utilization management team.

Salary

Base: $94,200.00 - $151,000.00; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • 5 years clinical or utilization management experience
  • 3 years management or leadership role
  • Current PA RN licensure or Social Work license
  • Proficiency in MS Excel and data analysis
  • Knowledge of healthcare delivery system costs

Nice-to-have

  • Certification in Case Management (CCM)
  • Bachelor's degree in Nursing preferred
  • Experience working with diverse populations
  • Ability to communicate in multiple languages
  • Direct experience with physician practice settings

Key Requirements

  • 5 years experience in Clinical, Utilization, Case, or Disease Management
  • 3 years in a management or leadership role
  • Clearances as required by specific practice or hospital
  • Current State of PA RN licensure OR multi-state eNLC
  • Current Social Work license (LSW, LCSW, LMSW, LBSW)

Work Rights

Not specified

Tailored Resume

Cover Letter