Manager, Care Management Services

Health Plans, Inc.; United States; On-site; USD 85,000 - 115,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

401(k) with company match

Bonuses

Job summary

Health Plans, Inc. seeks a Manager of the Case Management Team to provide day-to-day oversight and promote cost-effective health resource management to meet members' needs and improve outcomes.

You will mentor staff, perform audits, conduct 1:1s, and lead annual reviews while coordinating daily CM operations and collaborating with the Director on process improvements and URAC standards adherence.

Qualifications

• Active RN license in the United States
• 5+ years of clinical experience
• 3+ years’ experience as a Case Manager
• CCM certification required or preferred

Responsibilities

• Oversee day-to-day operations of the Case Management team.
• Conduct monthly audits of designated team members.
• Hold monthly 1:1 meetings with team members.
• Complete annual performance reviews for team members.
• Manage CM team's daily schedule, PTO and timesheets.
• Collaborate with CM team to balance caseloads and problem-solve.

Skills

Case Management

Mentoring

Auditing

Performance Reviews

Team Scheduling

Education

CCM Certification

Bachelor's Degree

Job description

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
• Collaborate with the Director regarding: Escalated member/Case issues
• Collaborate with the Director regarding: 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)

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
• Collaborate with the Director regarding: Escalated member/Case issues
• Collaborate with the Director regarding: 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

• 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

So, think you want to join the HPI team? We hope to hear from you!

You can read more about us at hpitpa.com/about-us/careers/

EEO/AA/M/F/Vet/Disability Employer