Case Management Manager

Job Description

Job Description

TITLE 

Manager, Case Management

POSITION SUMMARY

Individual reports to the Senior VP of Clinical Operations for all operational issues and the AMM or Client Medical Director for all clinical issues. The case management manager is critical to the success of AMM and as such is responsible for the implementation and ongoing management of all of the AMM case management programs. The manager will provide guiding principles, interventions and strategies that are targeted at the achievement of client stability, wellness, and autonomy through advocacy, assessment, planning, communication, education, resource management, care coordination, collaboration and service facilitation. 

 

RESPONSIBILITIES-DUTIES

• Review Inpatient cases and provides guidance to IP case managers for reviews, hospital transfers, observation, discharge planning, and transitions of care.
• Review outpatient cases and provides guidance to OP case managers for reviews, case management program overview and following the processes for disease management, complex case management and the management of DSNP. 
• Responsible to inspire the team to come up with creative ways to keep patients out of the hospital and have the best quality of care at home or in a care facility. Lead Monday nurse team meetings.
• Identifies, develops and oversees the educational needs of the team and motivates and leads the team in setting and reaching goals for improvement. 
• Work with the team to enhance the systems case management use
• Involved in the projects for the platform development for case management
• Recruits and retains CM team members
• Conducts annual performance appraisals
• Provides coaching and disciplinary activities with staff
• Participates in budget preparation if needed
• Analyzes staffing ratios and productivity levels

EDUCATION AND EXPERIENCE REQUIREMENTS 

• Have deep compassion for patients and the care they receive
• Valid California RN license
• Bachelor’s degree required, Master’s Degree in Nursing or Health – Related Major preferred
• CCM desirable
• Minimum of 5 years of UM and CM experience in an IPA/PMG or HMO setting
• Experience in management (hiring, counseling, terminations)
• Maintains confidentiality and adheres to HIPAA policies 
• Managerial skills necessary to independently manage on-site as well as remote team 
• Competent leadership and effective communication style (verbal & written) with proven ability to positively influence behavior and arrive at a “win-win” resolution when possible
• Strong clinical judgment necessary to interpret and follow medical guidelines
• Demonstrated skills in resolving complex issues
• Be courteous and promote professionalism 
• Be flexible and adaptable
• Promote organizational goals
• Know and follow safety standards 
• Analytical skills to review and interpret metrics

AMM BENEFITS

When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first:

• Health Coverage You Can Count On: Full employer-paid HMO and the option for a flexible PPO plan.
• Wellness Made Affordable: Discounted vision and dental premiums to help keep you healthy from head to toe.
• Smart Spending: FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future.
• Work-Life Balance: Generous PTO, 40 hours of sick pay, and 13 paid holidays to enjoy life outside of work.
• Career Development: Tuition reimbursement to support your education and growth.
• Team Fun: Paid company outings and lunches because we work hard, but we also know how to have fun!