Job Description

Job Description

The Manager, Care Management is directly responsible for the oversight and monitoring of care management functions, organization, direction and staffing of L.A. Care's Case Management function(s) including but not limited to Complex Case Management/Case Management, Care Coordination and Special Programs Outreach.

Responsibility includes regulatory compliance, accreditation compliance, oversight of Plan Partners' and Delegated Provider Groups related operations, oversight of  care management related delegated functions, operations for direct lines of business and/or management services agreement functions, and interfacing with external agencies including other Local Initiatives, Plan Partners and external organizations.

The Manager, Case Management is further responsible to assure all functions are operating in accordance with the organization's mission, values and strategic goals and are provided in a manner that is responsive and sensitive to the needs of L.A. Care's culturally diverse membership.

This position manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct-reports.

Qualifications

Education Required:

• Master's Degree in Social WorkOr Associate's Degree in Nursing

Education Preferred:

• Bachelor's Degree in Nursing

Experience Required:

• At least 4 years of recent care management experience in a hospital or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments.
• At least 3 years of management/supervisory experience and relevant health plan experience. Experience with Medi-Cal and Medicare populations and regulatory requirements.
• Equivalency:  Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement.

Preferred:

• Experience with Medi-Cal, under-served and culturally diverse populations.
• Experience with state Medi-Cal regulations.
• Audit/oversight experience.

Licenses/Certifications Required:

• Licensed Clinical Social Worker (LCSW); Current and unrestricted California License or Registered Nurse (RN)

Licenses/Certifications Preferred:

• Certified Case Manager (CCM)

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