Current Job Opportunities

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 JobTitleCityStateJobType
AR-CT-3838Care Manager - Little RockLittle RockAR 
AR-CT-3869Behavioral Care ManagerLittle RockAR 
AR-CT-3918VP, Quality & Process ImprovementLittle RockAR 
AR-CT-3931Sr. Manager, Enrollment - A & G - HICS   
CA-CT-3779Director, Medical Management - TWO POSITIONSRancho CordovaCA 
CA-CT-3926Director, Sales Large Group Health Insurance Woodland HillsCA 
CA-CT-3934Vice President, Strategic Provider PartnershipsWoodland HillsCA 
FL- CT- 3871Medical Director- LTC and Medicare ANY CITYFL 
FL-CT-3432Director, Case ManagementOrlando FL 
FL-CT-3711Director, Medicare STARSTAMPA OR SUNRISE FL 
FL-CT-3932Director, Provider Payment Innovations   
GA-CT-3882Sr. Director, Medical ManagementAtlanta GA 
GA-CT-3883Director, Case ManagementAtlantaGA 
GA-CT-3927Manager, Medical Management (Medicare) RN   
IL-CT-3642VP, Network Development & ContractingChicagoIL 
IL-CT-3781Medical DirectorWestmountIL 
IL-CT-3914VP, Health Plan Operations - Foster CareChicagoIL 
IL-CT-3922Director, ContractingChicagoIL 
IL-CT-3923Sr Director. Foster Care   
IN -CT-3925Manager, Case ManagementIndianapolisIN 
 
Job ID:AR-CT-3838
Job Title:
Care Manager - Little Rock
Rate:
Primary Skills:
Description:
CARE MANAGER – office based position in Little Rock

GROWING national company offers GREAT benefits and training.

Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care
Develop, assess and adjust, as necessary, the care plan and promote desired outcome
Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
Provide patient and provider education
Facilitate member access to community based services
Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan
Actively participate in integrated team care management rounds
Identify related risk management quality concerns and report these scenarios to the appropriate resources
Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
May perform some home visits to members

Qualifications:
Education/Experience: Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting. Knowledge of managed care preferred. Licenses/Certifications: Current AR RN license.
 
    
 
Job ID:AR-CT-3869
Job Title:
Behavioral Care Manager
Rate:
Primary Skills:
Description:
Behavioral Care Manager - Little Rock
____________________________________________________
GROWING national company - great training & benefits!

Office -based clinician will will work with improving health and well being for High Risk members in AR.  Case Management functions to include identifying needs and goals to achieve empowerment and improved quality of life. Assess members’ current functional level and, in collaboration with the member, develop and monitor the Case Management Treatment Plan, monitor quality of care; assisting with discharge planning, participating in special clinical projects and communicate with departmental and plan administrative staff to facilitate daily operations of the High Risk Case Management functions. Collaborate with both medical and behavioral providers to ensure optimal care for members.

Comply with established referral, pre-certification and authorization policies, procedures and processes by related Medical Management staff.
Participate in on-going communication between case management staff, utilization management staff, health plan partners and contracted providers.
Assist with the implementation of policies and procedures regarding case management and utilization management functions.
Maintain compliance with federal and state regulations and contractual agreements.
Coordinate case management functions with other departmental functions as assigned.
Monitor the effectiveness of existing procedures and outreach/intervention efforts.
Conduct appropriate knowledge/education and interventions for members defined to be at risk.
Monitor data to address trends or potential quality improvement opportunities including provider issues, service gaps, member needs.
Maintain HIPAA compliance.
Qualifications:
Education/Experience: Master's degree in Behavioral Health. LCSW, LMFT, LPC, PhD, PsyD or RN license. 3+ years of case and/or utilization management experience. Experience in psychiatric and medical health care settings. Working knowledge of utilization review procedures, and familiarity with mental health community resources. Thorough knowledge of a specialized or technical field such as clinical nursing, case and/or utilization management involving knowledge plus the application of basic theory.
License/Certification: Required to have license to practice independently, and/or have obtained the state required licensure as outlined by the specific state. This includes but is not limited to LPC, LCSW, LMFT, LMHC, LIMHP, or RN.
 
    
 
Job ID:AR-CT-3918
Job Title:
VP, Quality & Process Improvement
Rate:
Primary Skills:
Description:
Vice
President, Quality & Process Improvement – Little Rock


 


______________________________________________________________________________


Are you a healthcare quality
SME?  Our client’s growing Arkansas market need a leader to develop and
oversee QI programs and strategies.
   Reporting to the CEO, VP will
participate in the development and application of the business unit’s strategic
mission and vision.  You will identify and champion the selection of
process improvement activities across the enterprise.


 


    New position
offers a great opportunity to grow a team- strong career potential!


                            
Generous relocation, benefits & perks.



Drive performance improvement for HEDIS, Stars, State Contract Quality &
Pay for Performance/Withhold, Marketplace QRS and Medicare Quality metrics and
processes and other quality improvement opportunities as needed.


· 
Develop infrastructure and processes for management of activities related to
National Committee for Quality Assurance (NCQA) Accreditation and Healthcare
Effectiveness Data and Information Set (HEDIS) performance ensuring highest
level of accreditation


· 
Oversee the development and implementation of enterprise wide and market
specific process improvement programs


· 
Review and present results of quality interventions for clinical and
operational performance improvements and identify organizational risks to
executive management


· 
Develop and ensure consistent, reliable and valid application of data
collection and analysis for priority performance measures, including HEDIS, pay
for performance and contractual performance measures


· 
Review and analyze cost benefit and return on investment analyses for
organizational resource allocation and recommend action plans


·  Responsible
for building relationship and positioning the company as the “go to” source for state
of the art MCE Quality Metrics.






Qualifications:


-VP must have substantial senior experience leading Quality
functions for a health plan: Medicare, Medicaid, or Commercial


 


-Extensive experience with HEDIS, STARS, CAPHS, and/or
Provider Performance Plans




- Bachelor's degree in healthcare or related clinical field.


 


-MBA preferred.


 


-Experience with NCQA accreditation preparation and
auditing, including the analysis of HEDIS performance measures. 



- Certified Professional in Health Care Quality (CPHQ) preferred


-  RN License preferred.


 


 


 
 
    
 
Job ID:AR-CT-3931
Job Title:
Sr. Manager, Enrollment - A & G - HICS
Rate:
Primary Skills:
Description:
 
    
 
Job ID:CA-CT-3779
Job Title:
Director, Medical Management - TWO POSITIONS
Rate:
Primary Skills:
Description:
Director, Medical Management - CA - need 2 for new contract!
New region opening and it's a GREAT opportunity to bring your own ideas and creativity.
Strong leaderhsip support of programs of care management.  Director will work closely with the Medical Informatics team to identify trends that need to be addressed with program management.
- Responsible for Care Management clinical inter-rater reliability and monitoring important aspects of care.
- Effectively manages the activities of staff providing leadership and guidance.
•  Interviews, recommends for hire, and evaluates staff, and counsels and confronts unsatisfactory performance promptly and fairly and administers corrective action.
•  Identifies department goals and objectives, develops and communicates action plans through regular staff meetings and other communications, uses team approach to problem solve and sets clear expectations.
•  Identifies training needs and develops and participates in staff training. Provides a challenging and supportive environment and delegates appropriately. Seeks additional training opportunities through outside sources.
•  Analyzes work plans developed by subordinate managers and monitors the status of their work in relation to the overall schedule requirements.
•  Develops monitoring systems and measurements and exhibits a customer service philosophy.
•  Manages statistical and qualitative information concerning patient outcomes and physician/hospital practice patterns in accordance with health plans’ utilization standards.
•  Intervenes with hospital or physician contractors to examine cases to ensure methods for meeting these utilization standards while maintaining precedent for quality of case standards.
•  Determines and enforces - through functional groups - medical management requirements in accordance with real company needs, based on current regulations and state-of-the art product development.
•  Organizes and promotes medical management functions.
•  Evaluates and develops improved techniques for the control of quality and reliability.
•  Plans and develops improved techniques for the control of health care costs.
•  Plans, on a quarterly or longer basis, the overall use of resources.
•  Provides information and advice to higher level management related to medical management.
Qualifications:
Education/Experience: Bachelor’s degree in Nursing or equivalent required; Master’s degree in Health Services Administration or equivalent desired. Five years clinical experience in an acute care setting. Four years experience in quality management/improvement in a health care setting. Two years work experience in a managed care environment. Five years management experience in a health care setting. Three years medical management experience in an HMO setting desired
License/Certification: Must have and maintain current valid and unrestricted Registered Nursing (RN) license. Valid state driver’s license
 
    
 
Job ID:CA-CT-3926
Job Title:
Director, Sales Large Group Health Insurance
Rate:
Primary Skills:
Description:
 
    
 
Job ID:CA-CT-3934
Job Title:
Vice President, Strategic Provider Partnerships
Rate:
Primary Skills:
Description:
Vice President, Strategic Provider Partnerships - CA
Responsible for working with regional and corporate personnel to identify, build and implement business strategies that support this healthcare enterprise's provider network and product development initiatives.
Proven leader will work closely with most other departments to facilitate process improvement and strategic initiatives.
VP will direct and supervises staff in the development and implementation of Strategic Provider Partnership Initiatives.

VP develops, recommends and implements cross-functional plans and activities to achieve strategic initiatives; communicates insights, progress of challenges and presents resolution scenarios.

Tracks/reports status on strategic partnerships, risk adjustment, tailored network development and other activities to leadership teams.

Builds and maintains effective working relationships with cross-functional leaders and teams in order to identify, explore, present and implement business opportunities.

Maintains a service-oriented atmosphere within the Network Management department.

Ensures that team’s activities and business operations are carried out in compliance with company policies, and local, state and federal regulations and internal requirements.

Responsible for associates’ work climate and provides leadership for initiatives to make the department a great place to work.

This leader will be charged with advancing our goals to:
·      Better support the provider community by simplifying and improving provider experience
·       Leveraging analytics and practice transformation to improve performance
·       Collaborating with other leaders to redesign the delivery system and ensure our model of care supports provider needs
·       Supporting other strategic initiatives enabling providers to effectively serve our members.
 
Bachelor’s degree in business or health related field required
MBA preferred.
10+ years  managed care experience in a health plan, MSO, MCO, ACO is desired. May consider someone with provider managed care department experience with CA market experience.
 
    
 
Job ID:FL- CT- 3871
Job Title:
Medical Director- LTC and Medicare
Rate:
Primary Skills:
Description:
...MEDICAL DIRECTOR- LTC and
Medicare - FLORIDA! 




..........National health plan is growing and diversifying in the FLORIDA
market.  A physician seeking a purposeful career with an opportunity to
make a difference in the quality of care and access to care will thrive in this
role.




- Medical Director will collaborate with the Chief Medical Director to
direct and coordinate the medical management, quality improvement and
credentialing functions for the FL health plan.  Provides medical
leadership of all for UM, cost containment, and medical QI activities.  Be
part of planning and establishing goals and policies to improve quality and
cost-effectiveness of care and service for members. Performs medical review
activities pertaining to utilization review, quality assurance, and medical
review of complex, controversial, or experimental medical services. Supports
effective implementation of performance improvement initiatives for capitated
providers.




-  Participates with the Chief MD in the functioning of the physician
committees and oversees the activities of physician advisors. Utilizes the
services of medical and pharmacy consultants for reviewing complex cases and
medical necessity appeals. Participates in provider network development and new
market expansion as appropriate. Assists in the development and implementation
of physician education with respect to clinical issues and policies.




-  Identifies utilization review studies and evaluates adverse trends
in utilization of medical services, unusual provider practice patterns, and
adequacy of benefit/payment components. Identifies clinical quality improvement
studies to assist in reducing unwarranted variation in clinical practice in
order to improve the quality and cost of care. Interfaces with physicians and
other providers in order to facilitate implementation of recommendations to
providers that would improve utilization and health care quality. Reviews
claims involving complex, controversial, or unusual or new services in order to
determine medical necessity and appropriate payment.




•  Develops alliances with the provider community through the
development and implementation of the medical management programs. As needed, may
represent the business unit before various publics both locally and nationally
on medical philosophy, policies, and related issues. Represents the business
unit at appropriate state committees and other ad hoc committees






Requirements;




-  MD or DO - Board certified preferable in a primary care specialty

- The candidate must be an actively practicing physician.

- Previous experience within an MCO and/or conducting medical reviews is
preferred.

- Experience treating or managing care for a culturally diverse population
preferred.




License/Certifications:

• Board Certification through American Board Medical Specialties

• Current Florida medical license without restrictions.
 
    
 
Job ID:FL-CT-3432
Job Title:
Director, Case Management
Rate:
Primary Skills:
Description:
Director, Case Management - TAMPA

INNOVATIVE health plan truly values their nurses . The Director will be engaged in creating, defining and directing a complete Case Management Program across a diverse population.

This will encompass needs analysis and planning; working with executive leadership to ensure targets are met for the annual operating plan; ensuring compliance with Corporate, State and NCQA standards. Director will be asked to develop and implement methods, policies and procedures to improve the departments efficiency and overall effectiveness.

Exceptional benefit package and growth potential here !

We are interviewing candidates with a Bachelor's degree in Nursing or related field, an RN with at least 5 years of work experience in managed care and acute care settings with complex case management. Previous leadership will be important, including including hiring, training, and managing performance of staff.
 
    
 
Job ID:FL-CT-3711
Job Title:
Director, Medicare STARS
Rate:
Primary Skills:
Description:
Director, Medicare STARS – FT Lauderdale
Newly –created role will provide strategic leadership, guidance and manage the Medicare STARs for the Medicare Plans in the Florida market. 
RELOCATION package- great benefits- wonderful opportunities to grow!
•  Act as a leader and expert of Medicare Stars Program to ensure Healthcare Effectiveness Data and Information Set (HEDIS) and Stars objectives are met to support the overall goals
•  Develop, manage and coordinate clinical and non-clinical HEDIS and Stars-related activities
•  Integrate Stars activities with risk adjustment initiatives.
•  Work closely with various cross-functional teams, locations and departments to improve STARs outcomes for Medicare members
•  Serve as a business resource and subject expert for health plan quality and Medicare operations teams and all internal and external business partners
•  Closely follow CMS guidance and translate into business strategies and tactics
•  Partner with multiple stakeholders and business unit leadership to establish operational objectives and procedures
•  Perform analysis of enterprise-wide data and practices to identify opportunities for improvement at the local and national level
•  Lead cross functional efforts to develop, deploy and manage reporting dashboard.
•  Ensure policies and procedures are compliant with NCQA and CMS guidelines
Qualifications:
- Bachelor's degree in Nursing, Healthcare Administration or related field.
-7+ or more years of experience in managed care operations with emphasis on Medicare
- Must have experience with improving STARs outcomes.
- Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
- Knowledge of Center for Medicare/Medicaid Services, requirements for Special Needs Plans (SNP), Medicare Medicaid Plans (MMP) and NCQA oversight requirements preferred.
 
    
 
Job ID:FL-CT-3932
Job Title:
Director, Provider Payment Innovations
Rate:
Primary Skills:
Description:
 
    
 
Job ID:GA-CT-3882
Job Title:
Sr. Director, Medical Management
Rate:
Primary Skills:
Description:
Sr.
Director, Med Mgmt – Atlanta




National
healthcare enterprise – strong growth- RELOCATION- excellent benefits!


Direct medical management program including utilization management, case management, and quality improvement.

Develop department objectives and organize activities to achieve objectives.

Evaluate and implement changes to medical service functions and performance in relation to company mission, philosophy objectives and policies.

Participate as a subject matter expert in implementation of new health plan products.

Manage budget and forecast for strategic planning and key initiatives

Coordinate with operating departments on research and implementation of best practices

Responsible for the statistical analysis of programs related to utilization and case management

Participate in NCQA, State, and/or other accreditations of the Plan

Develop communication plans with external providers such as hospitals and State agencies as required to facilitate plan goals and objectives

Coordinate with Medical Director to educate and communicate expectations with providers.

Qualifications:
- Bachelor's degree in nursing, related field, or equivalent experience.
-7+ years of clinical nursing, quality improvement, and management experience in a managed care setting.
Current state nursing license - or willing to attain
Strong leadership/management experience is highly preferred.
CCM is desired.
Familiarity with Commercial, Medicare and Medicaid is a plus.
Program development and knowledge of NCQA and CMS standards is highly desired.
 
    
 
Job ID:GA-CT-3883
Job Title:
Director, Case Management
Rate:
Primary Skills:
Description:
 


 


 


Director,
Case Management – Atlanta


______________________________________________________________________________
                 Rich benefit package and generous relocation
Join an innovative leader in the health insurance industry as they continue to excel in managing care for their members in GA.
Director is responsible for defining and directing a complete Case
Management Program in conjunction with corporate goals and objectives




· 
Direct the overall operational leadership of case management functions
and staff




· 
Perform and oversee needs analysis and planning




· 
Work with executive leadership to ensure targets are met for the annual
operating plan/financial management




· 
Ensure compliance with Corporate, State and NCQA standards




· 
Develop and implement methods, policies and procedures to improve the
departments efficiency and effectiveness


 


Qualifications:




- Bachelor's degree in Nursing or related field.


-5+ years of work experience in
managed care and acute care settings with complex case management.


 


-Previous management experience
including responsibilities for hiring, training, assigning work and managing
performance of staff. 


 


- Case management and UM experience
- complex case management


 


- Familiarity with HEDIS and STARS
measures- quality components- QRS






- License/Certification: RN license.


 


 


Preferred:


 


Medicare background.


 


CCM - Case Management Certification


 






 


 


 


 


 
 
    
 
Job ID:GA-CT-3927
Job Title:
Manager, Medical Management (Medicare) RN
Rate:
Primary Skills:
Description:
 
    
 
Job ID:IL-CT-3642
Job Title:
VP, Network Development & Contracting
Rate:
Primary Skills:
Description:
Vice President, Network Strategy & Contracting
Innovative leadership- GENEROUS relocation
Experienced leader will drive all aspects of provider network strategy and execution of contracting activity.  This encompasses access analysis, network operations and providing decision makers with analysis and recommendations related to reimbursement and unit cost management. .
-Establish the contracting department’s strategic vision, objectives, and policies and procedures.
-Develop, implement and maintain production and quality standards for the Contracting department.
-Guide the network development staff and external consultants in the development of provider networks across expansion markets.
-Perform periodic analyses of the provider network from a cost, coverage, and growth perspective.
-Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts.
-Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations.
-Conduct periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy.
-Support market expansion and M&A activities by leading provider contract analysis related to due diligence.
-Assist health plan CEO and/or COO vendors in key provider relations and strategy.

Ideal Profile:
Bachelor's degree - MBA or MHA degree preferred.
10+ years of experience in a senior leadership role in managed care network development and provider relations in a managed care environment.
Proven leadership success including mentoring, staff development,  training, and managing performance.
-Innovation, drive for success and financial savvy.
.
 
    
 
Job ID:IL-CT-3781
Job Title:
Medical Director
Rate:
Primary Skills:
Description:
Behavioral Health Medical Director - Psychiatrist

Support the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the ILLLINOIS market as they move to a fully integrated model of care.
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Supports effective implementation of performance improvement initiatives for capitated providers.
Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members. Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.
Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership. Oversees the activities of physician advisors. Utilizes the services of medical and pharmacy consultants for reviewing complex cases and medical necessity appeals. Participates in provider network development and new market expansion as appropriate. Assists in the development and implementation of physician education with respect to clinical issues and policies.
Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components. Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care. Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality. Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment.
Develops alliances with the provider community through the development and implementation of the medical management programs. As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues. Represents the business unit at appropriate state committees and other ad hoc committees
Qualifications:BOARD CERTIFIED IN PSYCHIATRY
 Education/Experience: Medical Doctor or Doctor of Osteopathy.
Must be an actively practicing physician. Previous experience within a managed care organization is preferred. Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is preferred. Experience treating or managing care for a culturally diverse population preferred.
License/Certifications: Board Certification through American Board Medical Specialties. Current state medical license without restrictions.
 
    
 
Job ID:IL-CT-3914
Job Title:
VP, Health Plan Operations - Foster Care
Rate:
Primary Skills:
Description:
VP, Operations-
Foster Care


___________________________________________________________________________


Join the strategic
leadership team for this health plan establishing a new product offering in a thriving market.


What an amazing
opportunity to
influence the lives and the healthcare of thousands of children and provide
support for their guardians.  You will be entrusted to promote
innovation in the development of care models to improve health outcomes and
permanency for foster children


                  Generous
relocation – outstanding career potential


VP will drive the
development, implementation and operation of all health programs and
initiatives for the Foster Care population in Illinois.



Development of key performance metrics, policies, procedures, and pilot
programs

Ensure effective management of care to all foster children under contract

Oversee the development and implementation of Foster Care business strategy

Collaborate with system stakeholders such as Child Welfare Agencies, Court
Appointed Special Advocates (CASA) for children, Child Placing Agencies (CPA),
State Medicaid Departments, Foster Parents, Judges and others to represent
health needs and issues and identify ways to collaborate for better member
outcomes

Act as liaison and representative between the company and governmental or
regulatory agencies, including, response to agency requests, attendance and
participation in meetings and committees, and resolution of issues identified
by the Company or the agency

Collaborate and lead initiatives with internal stakeholders such as Network
Development and Provider Relations to improve health outcomes for the Foster
Care population

Ensure initiatives and processes are compliant with NCQA, contractual and
regulatory requirements, and best practice guidelines

Compile and review reports to identify utilization trends, solutions to
demonstrate positive outcomes and value to the system

Promote managed foster care to interested parties across the company

Qualifications:




-   Bachelor’s degree in Healthcare Administration, Business
Administration, Social Work, or related field. -   Master’s degree
preferred.


-  10+
years’ experience in managed healthcare operations, administration, and
management.


-  Must
have experience and knowledge of Foster Care and/or child welfare program


-- Must have
experience with Medicare/Medicaid programs


 


 
 
    
 
Job ID:IL-CT-3922
Job Title:
Director, Contracting
Rate:
Primary Skills:
Description:
 
    
 
Job ID:IL-CT-3923
Job Title:
Sr Director. Foster Care
Rate:
Primary Skills:
Description:
 
    
 
Job ID:IN -CT-3925
Job Title:
Manager, Case Management
Rate:
Primary Skills:
Description:
Manager, Case Management - Indianapolis
      Excellent opportunity for career growth - RICH benefits!
Experienec leader will oversee daily activity of the  case management taem.  This will include review and analyze activities, costs, operations and forecast data to determine progress toward target goals 
You will be instrumental in  developing, implementing, and maintain ing case management programs to facilitate the use of appropriate medical resources and decrease health plan financial exposure.
Promote compliance with federal and state regulations and contractual agreements.
Facilitate on-going communication between case management staff, members, contracted providers, and subsidiaries.

Develop staff skills and competencies through training and experience.
Qualifications:
Bachelor’s degree in Nursing or equivalent experience.
3+ years case management experience
Recent nursing experience in an acute care setting particularly in medical/surgical, pediatrics, or obstetrics and management experience.
Thorough knowledge of case and/or utilization management and clinical nursing.
Familiarity with Medicaid managed care practices and policies.
Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.
License/Certification: Unrestricted RN license in IN and valid driver's license and automobile insurance. Case Management Certification (CCM) helpful.