Manager Care Coordination/Disease Management

We are searching for a Manager of Care Coordination/Disease Management focused on non-pregnant adult and children for STAR/CHIP for The Health Plan – someone who works well in a fast-paced setting. In this position, you will manage staff and provide case management services to Texas Children's Health Plan members and to continually develop the identification, outreach, and delivery of social supports as needed to respond to the strategic goals of Texas Children's Health Plan as well as the needs of the members.
 

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Responsibilities
•    Plan, develop, organize, direct, implement and monitor a coordinated approach to case management services for TCHP members under the guidelines which responds to and meets the obligation of contractual agreements and legislative regulations
•    Provides case management for TCHP members including assessment, planning, implementation and evaluation of educational and social service related options
•    Develops approaches, policies and programs for case management which are based on the TCH goals and objectives and which meet the TCHP performance goals
•    Ensures the delivery of cost effective, community-based and culturally sensitive social case management interventions and continuous quality improvement monitoring. Collaborates to ensure member outcomes that address values of quality, service and cost effectiveness
•    Communicates and collaborates with members and providers with the goals of providing education on case management and community resources and to facilitate appropriate, timely, and cost effective care
•    Strives to achieve the goal of accreditation with commendation
 

Requirements
•    Bachelor's Degree Nursing (BSN)
•    RN - Registered Nurses Texas Board of Nursing or Nursing Licensure Compact
•    2 years Managed Care experience
•    5 years of experience in population health, community public health, ambulatory care, or healthcare administration
•    Experience in STAR/CHIP preferred
•    Previous supervisory experience is preferred 
 

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