Manager, Care Management Services
Health Plans Inc
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Benefits offered by this job
Job summary
Health Plans Inc. is seeking a Manager of Care Management Services to lead the Case Management team. This full-time role will drive clinical outcomes by overseeing care delivery and resource utilization across members.
The ideal candidate will hold an RN license, have 5+ years of clinical experience and 3+ years in case management, with CCM certification preferred. Strong leadership and collaboration skills are essential.
Qualifications
- Associate’s degree in nursing.
- Active, current and unrestricted RN license.
- 5+ years of clinical experience.
- 3+ years’ experience as a Case Manager.
- Certified Case Manager (CCM).
- Preferred: Bachelor’s Degree.
- Preferred: Supervisory experience.
Responsibilities
- Provide day-to-day oversight of the Case Management program.
- Perform monthly audits of designated team members.
- Hold 1:1 meetings with team members every month.
- Complete annual performance reviews of team members.
- Manage daily CM team schedule, PTO requests, and timesheets.
- Collaborate with the CM team to balance caseloads and mentoring.
- Coordinate with the Director on performance issues and workflows.
- Communicate with members, physicians and other health professionals about CM processes.
Skills
Education
Tools
Job description
If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.
Full Time Regular Management US
9 days ago Requisition ID: 1897
Salary Range: $115,000.00 To $125,000.00 Annually
Do you envision working for a company that has the expertise of a long-standing industry leader, but the spirit of an entrepreneur? Does the thought of making a real impact motivate and energize you? If so, HPI is the place for you. Join a team that values integrity, flexibility, loyalty, compassion and dedication—we can’t wait to meet you.
What we do
HPI is unique. A respected industry leader that’s been serving customers for over 44 years, we’re known for our innovation and adaptability. Our experience has given us our expertise, but our forward-thinking, entrepreneurial spirit has given us our strong reputation. As a third-party administrator, we offer a suite of health and benefit solutions to employers. By joining HPI, you’ll contribute to ideas that make a real difference for employers and employees nationwide. There isn’t a challenge we won’t accept and we’re looking for people who have a passion to take it on. Not just a job—a mission.
Our commitment extends beyond our clients to our own employees. We foster a supportive and inclusive work environment where innovation thrives. By investing in our team’s growth and well‑being, we ensure they are equipped to provide exceptional service.
What you’ll do
The Manager of the Case Management (CM) Team will provide day to day oversight of the Case Management program while promoting cost effective management of health resources in order to meet individual members’ health care needs and promote positive health outcomes.
In this role, you’ll also:
- Participates in the orientation and mentoring of new employees.
- Perform monthly audits of designated team members.
- Hold 1:1 meetings every month with designated team members.
- Will complete annual performance reviews of designated team member;
- Will manage daily schedule for the CM team as well as PTO requests and timesheets
- Will collaborate on a daily basis and as needed with the CM team to balance caseloads, assist in problem solving and mentoring;
- Collaborate with the Director regarding:
- Employee performance issues
- Escalated member/Case issues
- Maintaining up to date processes and workflows.
- Communicate with members/designees, physicians and other health care professionals regarding the Care Management process including information about the role of HPI, the Case Management program, policies and procedures, benefit coverage and determinations.
- Collaborate with other HPI Departments for issue resolution and process improvements as needed;
- Attend meetings as requested by the Chief Clinical Officer or the Director;
- Remain up to date on URAC standards and Utilization Management Policies & Procedures;
- Advocate for and promote the case management program
What you bring
- Associate’s degree in nursing
- 5+ years of clinical experience
- 3+ years’ experience as a Case Manager
Do you envision working for a company that has the expertise of a long-standing industry leader, but the spirit of an entrepreneur? Does the thought of making a real impact motivate and energize you? If so, HPI is the place for you. Join a team that values integrity, flexibility, loyalty, compassion and dedication—we can’t wait to meet you.
What we do
HPI is unique. A respected industry leader that’s been serving customers for over 44 years, we’re known for our innovation and adaptability. Our experience has given us our expertise, but our forward-thinking, entrepreneurial spirit has given us our strong reputation. As a third-party administrator, we offer a suite of health and benefit solutions to employers. By joining HPI, you’ll contribute to ideas that make a real difference for employers and employees nationwide. There isn’t a challenge we won’t accept and we’re looking for people who have a passion to take it on. Not just a job—a mission.
Our commitment extends beyond our clients to our own employees. We foster a supportive and inclusive work environment where innovation thrives. By investing in our team’s growth and well‑being, we ensure they are equipped to provide exceptional service.
What you’ll do
The Manager of the Case Management (CM) Team will provide day to day oversight of the Case Management program while promoting cost effective management of health resources in order to meet individual members’ health care needs and promote positive health outcomes.
In this role, you’ll also:
- Participates in the orientation and mentoring of new employees.
- Perform monthly audits of designated team members.
- Hold 1:1 meetings every month with designated team members.
- Will complete annual performance reviews of designated team member;
- Will manage daily schedule for the CM team as well as PTO requests and timesheets
- Will collaborate on a daily basis and as needed with the CM team to balance caseloads, assist in problem solving and mentoring;
- Collaborate with the Director regarding:
- Employee performance issues
- Escalated member/Case issues
- Maintaining up to date processes and workflows.
- Communicate with members/designees, physicians and other health care professionals regarding the Care Management process including information about the role of HPI, the Case Management program, policies and procedures, benefit coverage and determinations.
- Collaborate with other HPI Departments for issue resolution and process improvements as needed;
- Attend meetings as requested by the Chief Clinical Officer or the Director;
- Remain up to date on URAC standards and Utilization Management Policies & Procedures;
- Advocate for and promote the case management program
What you bring
- Associate’s degree in nursing
- Active, current and unrestricted Registered Nurse compact license or state of residency
- 5+ years of clinical experience
- 3+ years’ experience as a Case Manager
- Certified Case Manager (CCM)
Preferred Education Requirements:
- Bachelor’s Degree
Preferred Experience Requirements:
- Supervisory experience
Why choose us?
- We’re a people-first company and value giving back to our community. Ask us about our volunteer opportunities.
- Our space is a reflection of who we are—innovative, open and collaborative.
- We think feeling your best is an important factor in producing great work, so we embrace a “smart casual” dress code and work at ergonomic desks.
- Need to reenergize? When at our Westborough headquarters, take a break to chat in the onsite café, go for a walk on one of the beautiful trails in our office park, or get in a quick workout at one of the campus gyms.
Our Benefits Package
We care about you and believe the greatest gift you can give yourself, your family, and the world is a healthy you! We offer a comprehensive and competitive benefits package to help you lead a happy, healthy life, including:
- Medical, Dental and Vision and Prescription Drug Coverage
- Fitness Reimbursement Benefit
- Employee Assistance Program
- Flexible Spending Account & Health Savings Account
- 401(k) and Quarterly Bonuses
- Generous Paid-Time Off & Volunteering Opportunities
- Educational Assistance & Professional Development Opportunities
EEO/AA/M/F/Vet/Disabi lity Employer
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