Manager, Clinical Programs

The Program Manager will have overall management responsibility for the implementation, daily operation and evaluation of one or more clinical programs. Adhering to strategic goals and processes, the Program Manager will creatively pull together resources to ensure engagement goals and the delivery of Case and Disease Management services to program participants (Asthma, Diabetes, CHF, COPD, ESRD)

General Responsibilities:

·         Day to day management of care managers and administrative staff.

·         Responsible for participant engagement and retention.

·         Responsible for clinical and medical management outcomes in designated program

·         Coordinates collaboration with in-market care managers, social workers, physicians and other providers and provider services reps.

·         Coordinates activities between care managers and preferred vendors.

·         Ongoing evaluation and training of care managers.

·         Key contact for management team, physicians and members.

·         Day to day oversight of clinical interventions of care managers and preferred vendors in designated market.

·         Serves as expert on operations for designated program.

·         Assures development of training materials and workflows

·         Assists with external accreditation of the program.

Required Education & Experience

·         Minimum of eight (8) years relevant clinical experience

·         B.A. or B.S. in nursing or equivalent combination of education and experience 

·         Current R.N. License

·         Must apply and maintain RN License in all states served

·         CCM Certification preferred

·         Minimum five (5) years of supervisory experience within a healthcare setting required

·         Managed Care/ health plan and Disease Management experience preferred.

·         Comfortable with CHF, COPD, ESRD and diabetes disease processes and treatment

Required Knowledge, Skills, and Abilities

·         Passion and commitment to excellence

·         Leadership experience (i.e., coaching mentoring, staff development, project management)

·         Demonstrates an understanding of population management

·         Strong background in the application of evidence based medicine.

·         Positive attitude, solution oriented.

·         Strong team building and motivational skills.

·         Ability to work well as part of an interdisciplinary team

·         Ability to handle multiple tasks

·         Computer proficiency required (Internet, MSWord, Excel, Outlook)