R.A. Wylan & Co. Inc.,
Career Center

Director, Case Management –

Location: Atlanta, GA
Job Type: Direct Hire
Degree: Bachelor;
Date: 4/30/2018
Job ID: 02565542
Job Description
Director, Case Management – Atlanta
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  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