Manager Care Management - Federal Employee Program at Cambia Health Solutions, Inc

Work from home within Oregon, Washington, Idaho or Utah

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Who We Are Looking For:

Every day, Cambia's dedicated team of Manager of Care Management is living our mission to make health care easier and lives better. As a member of the Federal Employee Program leadership team, our Manager of Care Management leads and oversees care management professionals and support staff, setting performance standards and ensuring effective program execution across all Cambia plans, including case management, disease management, and care coordination. This role represents the department in interactions with internal and external stakeholders, including management, vendors, clients, providers, government officials, and consultants - all in service of making our members' health journeys easier. As a people leader, you are willing to learn and grow, understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us.

Are you a leader in healthcare looking for a new challenge? Do you have what it takes to lead a team and drive results in care management? Then this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

• Bachelor's degree in nursing or related field

• Master's preferred

• 7 years of healthcare or clinical care experience

• 5 years of leadership experience

• Equivalent combination of education and experience

• Current unrestricted Registered Nurse (RN) License or LPN in a state or territory of the United States

Skills and Attributes:

• Strategic Problem-Solving and Collaboration: Identify key issues, opportunities, and effective solutions, and collaborate with cross-functional departments to drive process improvements and optimize results.

• Resource and Project Management Expertise: Demonstrate proficiency in managing resources and projects, including budgeting, work organization, leadership, establishing success metrics, and delivering results.

• Team Leadership and Development: Develop and lead high-performing teams, including talent acquisition, goal setting, coaching, and development of supervisors and employees, regardless of location or work arrangement.

• Effective Communication and Presentation: Communicate complex ideas clearly and persuasively, both verbally and in writing, with the ability to facilitate meetings and deliver presentations to employer or provider groups.

• Industry Knowledge and Awareness: Stay abreast of the latest trends and technologies in the health insurance industry, ensuring informed decision-making and strategic planning.

• Clinical Case Management and Utilization Management Expertise: Demonstrate a deep understanding of clinical case management and utilization management best practices, ensuring high-quality patient care and optimal resource allocation.

• Data-Driven Care Management: Leverage population statistics to inform care management programs, driving data-driven decision-making and improved health outcomes.

What You Will Do at Cambia:

• Develops and executes care management policies, procedures, and standards to ensure quality and service excellence.

• Oversees staff management, including performance reviews, employee development, hiring, and retention, and participates in talent management activities.

• Communicates organizational objectives and team goals, monitors results and metrics, and collaborates with other leaders to resolve issues and ensure compliance with department and regulatory standards.

• Manages financial targets, department budget, and resource allocation, and oversees project plans to achieve operational goals.

• Establishes long-term department goals and adapts operational plans in conjunction with division leadership.

• Develops and provides education and communication about care management programs to employees, providers, and community stakeholders, and maintains clinical competency.

• Oversees development and implementation of department programs, ensuring program quality and successful outcomes.

• As a member of our strong leadership community, you will provide direction to your team, engage them towards common goals and create a positive experience that helps people flourish.

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