The position provides shared responsibility for the daily operations, activities and projects for the Case Management Department. This position will work under the general direction of the Director of Case Management and in partnership with the other department managers to provide performance management and development of the case management staff and projects associated with the department to ensure compliance with department policies and procedures along with the implementation of assigned projects. This position may require attendance at joint operational meetings. The incumbent is responsible for monitoring of case management reports and reporting to management or committees.
Bachelor’s degree in public health, health care, or related field; or equivalent work experience is required. Master’s degree preferred.
Active and unrestricted RN license or LCSW license to practice in the State of California required.
5 + years of managed care experience required.
5+ years of management level experience required.
Active CCM certification preferred.
CalOptima’s Manager, Case Management must possess the ability to:
Maintain and ensure confidentiality of patient information.
Communicate in both written and verbal formats.
Think analytically to evaluate potential courses of action.
Develop creative/innovative approaches to challenges and opportunities.
Utilize and access computer programs – both Microsoft Office applications and job-specific applications like Facets and Guiding Care.
Think independently and disagree constructively with peers and bosses.
Document and manage process for projects.
Effectively engage and lead a team of more than 20 employees or smaller teams of less than 5 toward a common goal or set of goals.
CalOptima’s Manager, Case Management must have the knowledge of:
National Committee for Quality Assurance (NCQA) QI 5 Standards; complex case management.
Principles and practices of managed health care.
Appropriate strategies to serve diverse populations.
Principles of effective supervision, team leadership, and staff engagement.
CalOptima provides an excellent benefits package including retirement benefits, PTO, 10 Holidays and much more.
For a complete job description and to apply online, please go to www.caloptima.org. Questions can be directed to Debbie Neal, Senior Recruiter, 657-235-6891 or email@example.com.
Internal Number: 12051-14293
CalOptima is a county organized health system that administers publicly funded health care coverage for low-income children, adults, seniors and people with disabilities in Orange County, California. CalOptima’s mission is to provide members with access to quality health care services delivered in a cost-effective and compassionate manner. With $3.6 billion in annual revenue, CalOptima serves nearly 800,000 members, delivering services through four programs, Medi-Cal, OneCare Connect, OneCare and PACE. For the past six years, CalOptima has been rated the top quality Medi-Cal plan in California, according to the National Committee for Quality Assurance (NCQA) Medicaid Health Insurance Plan Ratings 2019–2020.