Director of Care Management
Company: NTT Data Inc
Posted on: May 16, 2020
NTT Data seeks a full time, direct hire Director of Care Management
(with a clinical background) for our customer in Missoula, MT.
** NTT Data is assisting our healthcare client with the recruiting
efforts for this position. This is not a position with NTT
The Director Care Management is responsible for the overall
strategy, operational performance and outcomes of the department's
care management activities.
This position manages the design, development, and refinement of
care management and associated functions to create a continuum of
integrated care and experience for our members.
The director collaborates across the enterprise and with clients to
ensure that objectives are aligned, business strategies are
delivered and financial and compliance and quality objectives are
Provides leadership and operational oversight of Care Management
programs. Provides leadership and direction to the Care Management
team and is responsible for oversight and maintaining of URAC
The incumbent is expected to conduct all communication and
assignments professionally with peers, supervisors, subordinates,
vendors, customers, and the public.
ESSENTIAL JOB FUNCTIONS:
Essential job functions include the following. Other functions may
be assigned as business conditions change.
Strategic development and implementation of care management
Provide strategic direction, leadership, and operations oversight
to programs and staff to optimize efficiency and effectiveness of
Care Management operations
Responsible for maintaining confidentiality standards, as mandated
by URAC and HIPAA.
Collaborate with strategic partners to innovate, design and deliver
market differentiating health management strategies that align to
Communicates and collaborates with senior medical director and
Chief Medical Officer for medical management, clinical programs and
clinical issues that arise.
Direct operational readiness and regulatory/accreditation
compliance via formal processes such as policy and procedure,
program descriptions, auditing, training, and metric monitoring and
Lead the evaluation of program performance based on analysis of
data and market requirements to identify and act on opportunities
to enhance and improve.
Oversees the development and coordination of quarterly productivity
reports and client reporting.
Create and foster an environment where Care Management staff can
work effectively and efficiently.
Leads and directs a high performing team including interviewing and
hiring employees. Conducts performance evaluation and is
responsible for managing employees, including skill and career
development, policy administration, coaching on performance
management and behavior, employee relations and cost control.
Oversees the onboarding process of new Care Management staff and
training processes to ensure staff are set up for success.
Develop educational plans and implementation of annual training for
skill and career development of staff.
Works collaboratively with the implementation team and workflow
process when adding new clients.
Facilitate and monitor client reporting.
Oversee the cost savings analysis for the Case Management and
Utilization Management staff for the individual group plans.
Oversee URAC compliance and application/certification processes for
the Utilization Management Department.
Participate in administrative meetings with Care Management
customers, Account Representatives or other group contacts upon
request as assigned by supervisor.
Performs other duties and responsibilities as assigned.
To perform this position successfully, an individual must be able
to perform each essential duty satisfactorily. The requirements
listed below are representative of the knowledge, skill and/or
ability required. Reasonable accommodations may be made to enable
individuals with disabilities to perform the essential
Bachelor's degree in health care administration, healthcare
management, Bachelor of Science Nursing and 5 years of progressive
experience in the health care industry or 10 years of relevant
experience in lieu of degree.
3 years of progressive management experience.
Current licensed clinician
Demonstrated maturity, flexibility and capacity to navigate a
complex structure with strong critical thinking, problem
solving/conflict resolution skills.
Superior facilitation, written and oral communications skills to
convey complex ideas simply, through written reports and
Strong leadership skills with the ability to generate ideas,
support and commitment from constituents.
Demonstrated team building, mentoring and coaching skills with
experience leading professional staff.
Demonstrated knowledge of healthcare payer industry and business
Ability to see across the enterprise and identify potential risks
and issues that influence other ongoing work efforts.
Strong teamwork and interpersonal skills at all levels.
Must be able to work effectively with cross functional groups,
fostering teamwork with a commitment to quality.
Strategic thinking and critical decision making at an enterprise
The Company is an equal opportunity employer and makes employment
decisions on the basis of merit and business needs. The Company
will consider all qualified applicants for employment without
regard to race, color, religious creed, citizenship, national
origin, ancestry, age, sex, sexual orientation, genetic
information, physical or mental disability, veteran or marital
status, or any other class protected by law. To comply with
applicable laws ensuring equal employment opportunities to
qualified individuals with a disability, the Company will make
reasonable accommodations for the known physical or mental
limitations of an otherwise qualified individual with a disability
who is an applicant or an employee unless undue hardship to the
Company would result.
Keywords: NTT Data Inc, Missoula , Director of Care Management, Executive , Missoula, Montana
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