Manager, Case Management SNP
New
United StatesFull-TimeManager
Salary113,332 - 169,999 USD per year
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Job Details
- Experience
- Minimum 5 years of clinical case management experience; Minimum 1 year of experience supporting SNP programs
- Required Skills
- EHR
Requirements
- Active, unrestricted California RN license
- Associate’s or Bachelor’s Degree in Nursing
- Minimum 5 years of clinical case management experience
- Minimum 1 year of experience supporting SNP programs within a health plan environment
- Strong understanding of CMS SNP Model of Care and Medicare Advantage regulations
- Willingness to obtain RN licensure in additional company markets if needed
- Strong leadership and team development capabilities
- Proficiency with EHR systems and healthcare technology platforms
Responsibilities
- Lead, coach, and develop a high-performing case management team serving SNP members
- Ensure timely completion of Health Risk Assessments, Individualized Care Plans, and Interdisciplinary Care Team activities
- Monitor operational and quality performance metrics and implement improvement strategies
- Oversee regulatory audits, compliance initiatives, and quality assurance activities
- Collaborate cross-functionally with Utilization Management, HEDIS/STARS, Quality Improvement, and operations teams
- Analyze reporting trends and operational data to support strategic decision-making
- Promote a culture of accountability, collaboration, and continuous improvement
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