Manager Case/Disease Management

 
Position: Manager Case/Disease Management

Job ID: 148670

Location: US-TX-Bellaire

Department: Case/Disease Management

Talent Area: Professional - Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: Days

About Texas Children's Hospital

Texas Children’s Health Plan (TCHP) is the largest Texas Medicaid managed care organization, and is part of the Texas Children’s healthcare system. Founded in 1996, TCHP is the nation's first health maintenance organization (HMO) created just for children and pregnant women. Our 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 service areas (Harris, Jefferson, North East). Members of the plan receive care from our network of more than 4,000 primary care physicians, 8,000 specialists, and 110 hospitals. They can also receive care at The Center for Children and Women, a patient and family-centered medical home with two convenient locations for TCHP members who can have all their medical needs met in one place, receiving multiple services the same day. TCHP is a recognized leader at encouraging holistic care that empowers families to live healthier lives.   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 the 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 years’ experience in health delivery or a managed care organization required


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