About the job
Key Responsibilities:
- Oversee and manage the daily operations of case management functions, ensuring effective communication with departmental and administrative staff to optimize departmental efficiency.
- Analyze operational activities, costs, and forecast data to assess progress toward established goals, while providing insights for statistical and financial reporting.
- Ensure adherence to federal and state regulations as well as contractual obligations.
- Design, implement, and sustain policies and procedures related to medical case management, ensuring compliance at all times.
- Develop and maintain case management programs that promote the effective use of medical resources, aiming to minimize financial exposure for health plans.
- Facilitate ongoing communication among case management staff, members, contracted providers, and subsidiary organizations.
