Associate Director of Care Management

Provides clinical and administrative leadership under the direction of the Regional Director of Care Management. Facilitates collaboration between staff and other matrix partners for Medical Outreach/Quality activities. Partners with Regional Care Director as business owners for implementation of corporate goals, regional business plan, and other clinical programs at the regional level. Collaborates with Regional Care Director regarding the recruitment/retention of staff and acts as the direct manager of the clinical RN team.

Responsible for regional implementation of corporate and regional medical management strategies and goals in conjunction with the VP/Medical Director and the Regional Care Director. Supports the Regional Care Director in the daily operations of the department. Leads the clinical RN team in accordance with Regional goals.

Assist the Regional Care Director in the management of care strategy teams through monitoring and evaluation of care management staff performance activities in relation to established care metrics and data from quality evaluations. Acts as a mentor, subject matter expert, and clinical resource for the regional staff.

Collaborate with the Regional Care Director in providing decision support (interpretation) to the regional and corporate leadership teams through analysis of reports data, internal and external benchmarking and qualitative assessment of medical outreach activities.

Accountable for training & implementation of regional & corporate goals. Develop training programs in response to needs assessment, conducts training & provides coaching to staff in the use of information systems, care mgmt responsibilities & industry related resources. Manages internal & external professional development opportunities.

Maintain company operations by initiating, coordinating, and enforcing operational, personnel, and corporate medical policies and procedures. Maintain confidentiality of patient, client and proprietary company information. Maintain the stability and reputation of the company by complying with all appropriate regulatory and accreditation needs.

Assists the Regional Care Director with development of regional workflows/ processes to enhance efficiencies using a data driven approach. Subject matter expert and regional business owner for care management information systems and evidence based tools.

Requirements:

Registered Nurse with academic degree (Assoc/Bachelors/Master) in Nursing/HC (required)
Active, unrestricted RN license in State of Texas (required)
URAC-recognized case management certification (required)
5+ years registered direct clinical nursing experience
5+ years of managed care experience with exposure to multiple product lines (PPO, HMO, OA)
Strong computer literacy - with specific experience in care management systems
Strong analytics, training and presentation skills and Ability to think strategically
3+ years prior direct management experience

You'll find good people at Great-West. Our good people make us a good company to do business with and a great place to grow your career!

Great-West Healthcare, a division of Great-West Life & Annuity Insurance Company, is a national employee benefits provider with expertise in self-funding and health care management solutions. With sales offices across the United States, the division provides more than 5,000 companies with a suite of employee benefit products and services including traditional and consumer-driven health plans; COBRA, HIPAA, and flexible spending account administration; dental and vision plans; life insurance benefits, and short-term and long-term disability coverage. It operates a nationwide health care network that includes approximately 4,250 hospitals and 547,000 providers and provides coverage to 2 million people. Offering creative benefits solutions that engage employees and help business manage costs, Great-West Healthcare pioneers New Ideas from the Frontier of Health CareSM.

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