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Manager Case Management

Atlanta, GA

Manager Case Management

Job Description


You will love being mentored by the fantastic leadership of this medical management team! National healthcare enterprise is committed to improving the health of the medically underserved with a focus on whole health.


Lead and develop the case management team in enhancing outcomes for the members they serve.

-Review analyzes of activities, costs, operations and forecast data 

-Promote compliance with federal and state regulations and contractual agreements.

-Develop, implement, and maintain case management programs to facilitate the use of appropriate medical resources and decrease health plan financial exposure.

-Facilitate on-going communication between case management staff, members, contracted providers, and subsidiaries.

-Develop staff skills and competencies through training and experience.


Job Requirements


- Bachelor’s degree in Nursing or equivalent experience. 

-3+ years case management experience and recent nursing experience in an acute care setting particularly in medical/surgical, pediatrics, or obstetrics.

- Thorough knowledge of case and/or utilization management and clinical nursing. 

-Familiarity with Medicaid managed care practices and policies, CHIP, and SCHIP. 

-Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff. 

-License/Certification: Unrestricted RN license in applicable state(s) and valid driver's license and automobile insurance. Case Management Certification (CCM) is a plus

About MMS Group

MMS is a Managed Care executive search firm. We are Managed Care's complete recruiting resource.

Keywords: nurse manager, managed care, nurse jobs

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