Manager, Health Plan Contract Administration

It's more than a career, it's a calling
MO-SSM Health Saint Louis University Hospital 1201 Grand

Worker Type:

Regular

Job Highlights:
Preferred Skills: MSN or MBA, Case Management and Leadership experience.

Job Summary:
Manages the daily operations for the Care Coordination department, which includes RN Case Managers, Social Workers, and administrative team members.

Job Responsibilities and Requirements:
PRIMARY RESPONSIBILITIES
Develops and implements specific departmental goals, standards, and objectives which support the strategic plan and vision.
Assesses quality of patient care and coordinates patient care services with patients, staff, physicians, and other departments. Provides bidirectional communication between leadership and frontline staff,
Collaborates with others regarding orientation and ongoing education. Provides coaching and mentoring of staff . Ensures staff compliance with departmental and organizational policies, procedures, and standard work.
Interacts with staff daily, identify gaps/barriers to process, escalates and brings gaps/barriers to resolution .
Participates with other members of team regarding opportunities for improvement in standard work .
Monitors departmental budgets, regulatory compliance, departmental contracts and vendor relations.
Manages staff relations including performance management, staff satisfaction and conflict management. Performs and oversees scheduling, recruitment, and payroll .
Applies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient’s age-specific needs and clinical needs as described in the department's Scope of Service
Works in a constant state of alertness and safe manner.
Performs other duties as assigned.

EDUCATION
~ Bachelor’s degree in nursing or Masters in social work

EXPERIENCE
~ Five years’ experience, with two years’ progressive leadership

PHYSICAL REQUIREMENTS
Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
Frequent keyboard use/data entry.
Occasional bending, stooping, kneeling, squatting, twisting and gripping.
Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
Rare climbing.

REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS 

State of Work Location: Illinois
Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR)
Or 
Licensed Clinical Social Worker (LCSW) - Illinois Department of Financial and Professional Regulation (IDFPR)

State of Work Location: Missouri
Registered Nurse (RN) Issued by Compact State 
Or
Registered Nurse (RN) - Missouri Division of Professional Registration
Or 
Licensed Clinical Social Worker (LCSW) - Missouri Division of Professional Registration
Or
Licensed Master Social Worker (LMSW) - Missouri Division of Professional Registration

State of Work Location: Oklahoma
Registered Nurse (RN) Issued by Compact State 
Or
Registered Nurse (RN) - Oklahoma Board of Nursing (OBN)
Or
Licensed Clinical Social Worker (LCSW) - Oklahoma State Board of Licensed Social Workers
Or
Licensed Master's Social Worker (LMSW) - Oklahoma State Board of Licensed Social Workers

State of Work Location: Wisconsin
Registered Nurse (RN) Issued by Compact State 
Or
Registered Nurse (RN) - Wisconsin Department of Safety and Professional Services
Or
Licensed Clinical Social Worker (LCSW) - Wisconsin Department of Safety and Professional Services

Work Shift:
Day Shift (United States of America)

Job Type:
Employee

Department:
8570000037 Case Management

Scheduled Weekly Hours:
40

Benefits:

SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.

Paid Parental Leave : we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). 
Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
Upfront Tuition Coverage : we provide upfront tuition coverage through FlexPath Funded for eligible team members. 

SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status , or any other characteristic protected by applicable law. Click here to learn more.