Manager, Integrated Care Management - Nursing, Carepartners Of Connecticut

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.

Job Summary

Please note - this position will require residency in the state of Connecticut

Under the general direction of the Director of Medicare & Commercial Care Management, the Manager, Integrated Care Management for CarePartners of Connecticut is responsible for day-to-day operations and staff within his/her jurisdiction. The Manager, Integrated Care Management for CarePartners of Connecticut is responsible for implementation, monitoring and oversight of care management functions and programs, including assurance of quality evidenced based care management practice, adherence to regulatory and accreditation standards; and to delivery of defined metrics to validate business unit/program effectiveness. The Manager, Integrated Care Management for CarePartners of Connecticut works collaboratively within Clinical Services and other Point32Health partners departments to identify and address opportunities to improve service, reduce administrative cost and support department, Medicare & Commercial markets and organizational business goals. Manager, Integrated Care Management for CarePartners of Connecticut is also accountable for recruitment, evaluation, management and ongoing development, of care management department staff, working in a remote and/or office environment.

Key Responsibilities/Duties - what you will be doing

Business Process Implementation and Oversight:

Responsible for implementation and monitoring effectiveness of new and existing Care Management programs, including but not limited to:

• Telephonic care management and onsite transition of care interventions

• Compliance with applicable regulatory and accrediting standards; care management process and interventions consistent with national best practices; demonstrated through scheduled department and quality audits

• Defining and monitoring outcomes and regular reporting for areas of accountability

• Interface with Care Management vendors and programs for bidirectional referrals

• Establishment of written policies and procedures pertaining to Care Management

Staff Development

• Provide direct oversight of coordinators, RN care managers working in a remote and/or office based environment

• Guide and enhance the core competencies and professional development of reporting staff

• Facilitate and enhance team collaboration to optimize program and member outcomes through integrated services

• Facilitate collaboration with internal and external stakeholders to maximize partnerships for case management program success, including alignment with provider network

• Serve as consultant and resource for complex situations

Resource Management

• Oversee the management of department human resources related objectives

• Support realization of department administrative budget targets

Corporate Participation

• Represent Care Management in relevant corporate teams as required

• Implement and support fulfillment of corporate objectives within jurisdiction

Qualifications - what you need to perform the job

EDUCATION: (Minimum educations & certifications required)

BA/BA degree required; Registered Nurse or Social Worker with current unrestricted Connecticut license required

National Certification in Case Management is preferred or required within 2 years of filling position

EXPERIENCE: (Years of experience)

Minimum of 5 years of RN/SW experience in clinical setting

Experience in managed care systems and operations, is highly desirable and must demonstrate sound knowledge of care management principles

Expertise in oversight of business process change and leading people is preferred

Compensation & Total Rewards Overview

As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company's sole discretion, consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

• Medical, dental and vision coverage

• Retirement plans

• Paid time off

• Employer-paid life and disability insurance with additional buy-up coverage options

• Tuition program

• Well-being benefits

• Full suite of benefits to support career development, individual & family health, and financial health

For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do-from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.