Director, Care Management in Anderson, CA at Beacon Health Options

Date Posted: 3/29/2020

Job Snapshot

Job Description

We Help People Live their Lives to the Fullest Potential!

For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a ‘world-class’ candidate experience from the moment you click ‘Apply’! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise.

Do you have a passion for helping others? If so, we are looking for you!

Beacon is currently seeking a Director, Care Management a highly organized and compassionate professional to join our team at our NorCal offices.  The Director, Care Management lead is responsible for all Care Management programs supervision and oversight for all care management programing. This includes ensuring compliance with NCQA and/or URAC standards for Case Management and Disease Management programs. Works closely with UM shared services ensuring all CM services are provided to all referrals.         

What does a typical day look like?

  1. Leads and supervises Care Management/Disease Management activity across multiple engagement centers/clients.
  2. Provides supervision to all case management team leads and clinical CM managers
  3. Oversees compliance with internal and client CM Audits
  4. In collaboration with the Clinical/Quality operations leads, care management staff, Shared UM Services, identify opportunities to streamline workflows that result in accurate, high quality production standards and improved results in cost savings, or outcomes measurement
  5. Complete annual evaluations on Disease Management programs, Care Management programs working with analytic team in the evaluation of regional or plan specific case management programs as required.
  6. Develop materials and presentations on Programs for current customers and new business opportunities if requested
  7. Develop effective working relationships with and provide high quality service for external and internal customers
  8. Work with corporate quality, regional quality and across CM pods to ensure standardization of NCQA/URAC program requirements
  9. Work with UM shared service leadership to create process flows supporting CM program, care coordination protocols ensuring timely completion of all inquiries.
  10. Attend and participate in Clinical and Quality department meetings as assigned
  11. Development of custom CM reports if indicated and monitors all CM key performance indicators
  12. Tracks and monitors all metrics related to CM programing, implementing plans for improvement as necessary
  13. Meets with other CM pod leads and regions in development of programs as indicated
  14. Performs special projects and other duties as assigned and required.

What you Contribute?

Education: Master’s Degree or higher in a health related field

Licensure: Independently licensed behavioral health clinician required (RN, LCSW, LMFT, PhD or PsyD)

  • Current, valid and unrestricted licensure for independent practice required with proof on date of hire. Re-verification will take place no less than every 3 years.

Knowledge, Skills & Abilities:

  • A minimum of 5-7 years combined direct behavioral health, supervisory and/or managed care experience required.
  • The Director, Care Management must have, or be working toward certification in Case Management. If she/he has supervised the case management process for three years or more, s/he must hold a certification as a case manager.
  • Leadership skills and supervisory experience, including the ability to develop team performance
  • Excellent written and oral communication skills
  • Self-motivated, able to prioritize multiple issues, excellent organizational skills, ability to track multiple projects/tasks and follow through as needed.
  • Demonstrated understanding of CQI.
  • Ability to manage and coordinate with internal and external departments
  • Ability to manage staff in operations environment
  • Demonstrated leadership skills and experience, including the ability to work cross-functionally, build consensus and develop staff
  • Ability to manage time-sensitive projects and meet deadlines
  • Knowledge of CQI principles and ability to manage change
  • Ability to identify opportunities for improvements and recommend and implement innovative solutions.
  • Able to work collaboratively with internal staff and external providers
  • Must be detail oriented; able to work independently in an ever changing environment
  • Must have excellent communication and negotiation skills.
  • Traveling required: 30%-35% travel NorCal (or on sight at plans)

What Makes Us Different?

  • Here, it’s not just a job – it’s an opportunity to change lives.
  • Our employees are learners, innovators and original thinkers.
  • Our mission and values guide the way we treat our members, providers and each other.

What We Have to Offer:

  • Healthcare benefits available starting day 1!
  • Health & wellbeing incentives, such as gym membership reimbursement
  • 401K with company match to help reach your future financial goals
  • Generous PTO, because we know life happens outside of work
  • Tuition reimbursement so you can keep reaching your fullest potential

If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started!

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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