Role Overview:
Join our dynamic team as the Manager of Integrated Care Operations, overseeing the daily functions of both Complex Care Management and Behavioral Health teams. This vital position, under the guidance of the Director of Clinical Market Population Health, ensures compliance with state and federal regulations while striving to meet our business goals.
Work Arrangement:
- Must reside in South Carolina.
- Ability to travel based on business needs.
Key Responsibilities:
- Plan, organize, and lead the development and execution of Case Management operations, ensuring that staff receive comprehensive training and ongoing professional development.
- Identify areas for improvement and collaborate with the Director on strategic planning initiatives.
- Implement and monitor departmental policies, goals, and objectives, ensuring compliance with NCQA standards, state, and federal regulations.
- Assess existing programs and services for effectiveness, and explore new initiatives to enhance cost efficiency and improve health outcomes.
- Support the corporate Population Health Strategy through active participation and collaboration.
- Ensure that case management activities adhere to requirements set forth by the state Department of Health and Human Services (DHHS).
- Foster cross-departmental collaboration to achieve organizational objectives.
- Promote a positive work environment that encourages teamwork and respect, and maintain effective communication with employees, providers, and external entities.
- Perform additional duties and projects as assigned.
Education and Experience:
- Bachelor's degree in nursing or a related health field.
- A minimum of 3 years of professional clinical experience in medical and behavioral health settings.
- At least 1 year of case management experience in a clinical managed care environment, preferably in a Medicaid unit.
- Over 3 years of progressive leadership experience, including 1 year in a managed care organization.
- Experience managing a remote team of approximately 40 licensed and unlicensed associates.
- Proven track record of leading projects with both internal and external stakeholders.
- Strong change management expertise.
Licensure Requirements:
- Valid Driver's License and car insurance.
- Active MSW with current and unrestricted LCSW/LMSW in South Carolina (in lieu of RN license).
- Current and unrestricted RN license in South Carolina is strongly preferred.
Your career begins here. We are looking for the next generation of healthcare leaders.
At AmeriHealth Caritas, our passion lies in helping individuals receive care, stay healthy, and build vibrant communities. As a leader in healthcare solutions, we provide talented associates the chance to positively influence the lives of millions through our expansive range of products, services, and acclaimed programs. We invite you to be part of our mission to create healthier communities.
Discover more about us at
Our Comprehensive Benefits Package:
We offer flexible work solutions, competitive pay, paid time off (including holidays and volunteer events), health insurance coverage from Day 1 for you and your dependents, 401(k) plans, tuition reimbursement, and more.
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