Manager - Case and Disease Management

 
Position: Manager - Case and Disease Management

Job ID: 148783

Location: US-TX-Bellaire

Department: Behavioral Health

Talent Area: Professional - Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8am-5pm

About Texas Children's Hospital

The Texas Children’s Hospital system is the largest pediatric integrated care system, and is an industry leader in pediatric population health. Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children and pregnant women. We are an Integrated Community System providing holistic care that empowers families to live healthier lives. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. Currently, the Health Plan serves more than 450,000 members across three state territories (Harris, Jefferson, North East), who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. To join our community of 13,000 dedicated team members, visit www.texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at www.infinitepassion.org

Summary:

We are searching for a Manager of Case and Disease Management – someone who works well in a fast-paced setting. In this position, you’ll supervise and provide social case management services to our client's health plan members. You'll also be expected to continually develop the identification, outreach, and delivery of social support as needed to respond to the strategic goals of the client.

 

Think you’ve got what it takes?



Responsibilities :

 

  • Plan, develop, organize, direct, implement, and monitor a coordinated approach to social case management services for our client’s members under the guidelines which meet the obligation of contractual agreements and legislative regulations
  • Provide social case management for our client’s members including assessment, planning, implementation, and evaluation of educational and social service related options
  • Develop approaches, policies, and programs for social case management based on the client’s goals and objectives which also meet the client’s performance goals
  • Ensure the delivery of cost-effective, community-based, and culturally sensitive social case management interventions and continuous quality improvement monitoring while collaborating to ensure member outcomes that address values of quality, service, and cost effectiveness
  • Communicate and collaborate with members and providers to provide education on case management, community resources, and to facilitate appropriate, timely, and cost-effective care
  • Strive to achieve the goal of accreditation with commendation through fulfilling the NCQA requirements specific to your department


Qualifications:

  • Bachelor’s degree in health education, social work, nursing, or public health required
  • Clinical Social Worker, Master Social Worker, or Registered Nursing license with the State of Texas required
  • Case Management Certification preferred
  • Five (5) years’ experience in health delivery or managed care organization


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