Remote Lead, TRICARE Case Management Programs

TriWest Healthcare Alliance Corp.; Phoenix (AZ); Remote; USD 101,000 - 119,000; Full time

Benefits offered by this job

Medical, Dental and Vision Coverage

Paid time off

401(k) Retirement Savings Plan (with匹配

Short-term and long-term disability

Tuition reimbursement

Paid volunteer time

Job summary

TriWest Healthcare Alliance Corp. is seeking a Manager to lead a team delivering benefit administration, prior authorization and care coordination for TRICARE beneficiaries under the ECHO and Autism Care programs.

You will report to the Director of Case Management and develop components to optimize CM and Care Coordination strategies while ensuring compliance with contract standards. The role requires RN/LCSW/BCBA credentials with DoD background eligibility, plus five years of clinical

Qualifications

• Required RN, LCSW or BCBA with BACB certification.
• Bachelor’s degree in health-related field with clinical experience.
• U.S. citizenship for TRICARE contract.
• Minimum 5 years clinical management experience in CM or care coordination.

Responsibilities

• Direct operational leadership of CM Special Program functions and staff.
• Monitor day-to-day operations to identify barriers to service.
• Evaluate staff performance and provide coaching and annual appraisals.
• Manage resources to maintain standards of care and efficiency.
• Develop measurable outcomes and monitor program impact on beneficiaries.
• Plan orientation and training for new hires.
• Ensure adherence to accreditation standards and contract requirements.
• Participate in desk procedures, education, and audits to support consistency.
• Participate in interdepartmental committees relevant to responsibilities.
• Perform other duties as assigned.

Skills

Leadership

Communication

Multitasking

Problem solving

Delegation

Information management

Team building

Clinical knowledge

Education

RN or LCSW or BCBA with BACB

Bachelor's degree in health-related field

Five years clinical management experience

U.S. citizenship

Job description

TriWest Healthcare Alliance Corp. is seeking a Manager to lead a team delivering benefit administration, prior authorization and care coordination for TRICARE beneficiaries under the ECHO and Autism Care programs.

You will report to the Director of Case Management and develop components to optimize CM and Care Coordination strategies while ensuring compliance with contract standards. The role requires RN/LCSW/BCBA credentials with DoD background eligibility, plus five years of clinical