Care Management Support Lead

CarePlus Health Plans Inc

Remote
$86,300 - $118,700 py; bonus incentive plan availa...
**
Clinical knowledge and critical thinking
Stakeholder coordination and communication
Process improvement and operational efficiency
** CarePlus Health Plans Inc. is seeking a Care Management Support Lead, responsible for coordinating care management efforts between market and enterprise teams in a remote setting. The ideal candidate will possess clinical expertise, leadership experience, and a strong understanding of regulatory requirements in healthcare. **

Job Summary

  • Responsible for coordinating with and bridging gaps between market care management and enterprise HIDE SNP care management teams.
  • Collaborates with plan leadership on process improvements, trends analysis, and operational efficiencies, reporting on departmental performance.
  • Fosters positive relationships with MDHHS, local and state health agencies, subcontractors, providers, and community organizations.

Matching Summary

Match Score: 75

** CarePlus Health Plans Inc. is seeking a Care Management Support Lead, responsible for coordinating care management efforts between market and enterprise teams in a remote setting. The ideal candidate will possess clinical expertise, leadership experience, and a strong understanding of regulatory requirements in healthcare. **

Salary

$86,300 - $118,700 per year; Bonus incentive plan available; Medical, dental, vision, 401(k), time off

Skills & Requirements

Must-have

  • Clinical knowledge and critical thinking
  • Stakeholder coordination and communication
  • Process improvement and operational efficiency
  • Compliance with policies and regulations
  • Microsoft Office proficiency

Nice-to-have

  • Relationship building with community partners
  • Data analysis for care gap identification

Key Requirements

  • Michigan residency required
  • Bachelor's degree in nursing or social work
  • Active, unrestricted Michigan RN or LSW license
  • 5+ years clinical experience (UM, Case Management, Managed Care)
  • 2+ years leadership experience
  • Knowledge of Medicare/Medicaid regulations and NCQA Standards
  • Experience with electronic case notes documentation

Work Rights

Not specified

Tailored Resume

Cover Letter