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RN Manager of Case Management

Open 58d
  • Position Purpose: Perform duties to conduct and manage the day to day operations of the case management functions communicating with departmental and plan administrative staff to facilitate daily department functions.


  • Review analyzes of activities, costs, operations and forecast data to determine progress toward stated goals and statistical/financial purposes.
  • Promote compliance with federal and state regulations and contractual agreements.
  • Develop, implement and maintain compliance with policies and procedures regarding medical case management.
  • Develop, implement, and maintain case management programs to facilitate the use of appropriate medical resources and decrease health plan financial exposure.
  • Facilitate on-going communication between case management staff, members, contracted providers, and subsidiaries.
  • Develop staff skills and competencies through training and experience.

Main qualifications:

  • RN license
  • Bachelors Degree or equivalent (BS "equivalent" would mean at least 4 years of experience)
  • 3-7 years of case management experience
  • Experience in an acute care setting (hospital, med/surge)
  • Management experience (progressive discipline, workflows, productivity reports, team building, reviews, hiring/firing)
  • Needs to be organized
  • Must have good computer skills - Excel, Outlook, etc

Soft skills needed - these are crucial:

  • Needs to be able to kindly keep a team on track - must be both firm and kind.
  • Not looking for a "task master" but need to be comfortable redirecting people.
  • The Directors in this department are direct, but polite and fair & that's what they're looking for in their managers.

Preferred but not required:

  • CM Certification
  • Managed Care experience


Interested in hearing more about this great opportunity? Please click Apply or call Ashley Greene at 407-478-0332 Ext. 169


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