3,506 Cary Medical Management jobs in the United States

**Job Summary**
The Chief Quality Officer (CQO) is responsible for leading and coordinating quality improvement and performance initiatives throughout the hospital. This role ensures compliance with regulatory standards, including The Joint Commission (JC), and serves as a liaison between hospital departments, medical staff, and administration on all quality-related matters. The CQO develops, implements, and monitors performance improvement plans to ensure continuous improvement in patient care and operational excellence.
**Opportunity for Relocation Assistance**
**What We Offer:**
+ Competitive Pay
+ Medical, Dental, Vision, and Life Insurance
+ Generous Paid Time Off (PTO)
+ Extended Illness Bank (EIB)
+ Matching 401(k)
+ Opportunities for Career Advancement
+ Rewards & Recognition Programs
+ Exclusive Discounts and Perks*
**Essential Functions**
+ Oversee the development, coordination, and implementation of the hospital's performance improvement plan, ensuring alignment with quality and regulatory standards.
+ Serve as a quality liaison between all hospital departments, medical staff, performance improvement committees, and administration to ensure a cohesive approach to quality improvement initiatives.
+ Chair the performance improvement committee, leading quality improvement efforts and ensuring compliance with Joint Commission (JC) regulations and other accreditation standards.
+ Act as the primary contact for all JC-related activities, including surveys, applications, and correspondence, ensuring continuous regulatory compliance.
+ Provide education to hospital staff and medical teams on quality standards, performance improvement methodologies, and regulatory updates.
+ Develop and conduct in-service education programs to enhance staff knowledge of quality improvement and regulatory standards, including OSHA, CDC, and JC requirements.
+ Maintain complete records of all performance improvement activities and ensure accurate documentation for regulatory reviews.
+ Update hospital staff on changes to regulatory standards and ensure timely communication of new quality initiatives.
+ Act as a resource to all departments on quality and performance improvement matters, providing guidance and support for quality-related challenges.
+ Lead the JC Task Force to ensure ongoing compliance with regulatory requirements and prepare the hospital for accreditation surveys.
+ Coordinate medical staff performance improvement activities, working closely with clinical teams to enhance patient outcomes.
+ Review and disseminate updated information from professional journals, ensuring staff have access to the latest developments in quality and performance improvement.
+ Perform other duties as assigned.
+ Comply with all policies and standards.
**Qualifications**
**Licenses and Certifications:**
+ **RN - Registered Nurse** (State Licensure and/or Compact State Licensure required).
+ **Certified Professional in Healthcare Quality (CPHQ)** designation preferred (Arizona-specific requirement).
**Education:**
+ Bachelor's Degree in Nursing, Healthcare Administration, or a related field required.
+ Master's Degree in Public Health, Healthcare Quality, or a related field preferred.
**Experience:**
+ 5-7 years of direct experience in nursing, quality management, performance improvement, or a related field required.
+ 5-7 years of progressive leadership experience in nursing, quality management, performance improvement, or a related field required.
+ Working knowledge of general hospital operations, JC standards, CMS requirements, and DOH regulations required.
+ 5-7 years of clinical nursing experience at an acute care facility preferred.
**Knowledge, Skills, and Abilities**
+ Strong knowledge of quality improvement methodologies, regulatory compliance, and accreditation standards, including Joint Commission (JC).
+ Excellent leadership and communication skills, with the ability to collaborate across departments and with medical staff.
+ Experience in data analysis, performance metrics, and the development of quality improvement initiatives.
+ Proficiency in healthcare regulations and compliance, with a focus on patient safety and performance improvement.
+ Ability to analyze trends, create reports, and implement best practices for hospital-wide quality improvements.
+ Adept at problem-solving and implementing solutions to improve patient outcomes and hospital performance.
**State-Specific Requirements**
+ **Arizona:** Certified Professional in Healthcare Quality (CPHQ) designation preferred.
This position plays a vital role in ensuring high-quality patient care and maintaining compliance with national healthcare standards. The ideal candidate will demonstrate strong leadership, regulatory knowledge, and a passion for quality improvement in a hospital setting.
INDLEAD
Equal Employment Opportunity
This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to to obtain the main telephone number of the facility and ask for Human Resources.

Our client, a prominent healthcare provider, is seeking an experienced Senior Operations Manager to lead and optimize their administrative functions. This position is fully remote, offering the flexibility to manage critical operations from anywhere in the US. You will be responsible for overseeing daily administrative operations, improving workflow efficiency, managing staff, and ensuring compliance with healthcare regulations. The ideal candidate possesses a strong background in healthcare administration, exceptional organizational skills, and a proven ability to drive operational excellence. You will work on implementing strategic initiatives, managing budgets, and ensuring the highest standards of patient service and administrative support. This role involves significant collaboration with clinical staff, IT departments, and external stakeholders to streamline processes and enhance the overall patient experience. Your leadership will be crucial in fostering a productive and efficient administrative environment.

Key Responsibilities:

• Oversee the day-to-day administrative operations of designated healthcare departments.
• Develop and implement strategies to improve operational efficiency and patient flow.
• Manage administrative staff, including hiring, training, scheduling, and performance evaluation.
• Ensure compliance with all relevant healthcare laws, regulations, and accreditation standards.
• Manage departmental budgets, control expenses, and identify cost-saving opportunities.
• Develop and implement policies and procedures to enhance administrative processes.
• Collaborate with clinical leadership and other departments to ensure seamless operations.
• Oversee the implementation of new administrative systems and technologies.
• Monitor key performance indicators (KPIs) and generate reports for senior management.
• Resolve operational issues and implement solutions to improve service delivery.

Qualifications:

• Master's degree in Healthcare Administration, Business Administration, or a related field.
• Minimum of 7 years of experience in healthcare operations management, with a focus on administrative functions.
• Strong knowledge of healthcare regulations (e.g., HIPAA, CMS) and compliance requirements.
• Proven experience in process improvement, workflow optimization, and change management.
• Excellent leadership, team management, and communication skills.
• Proficiency in budgeting, financial management, and data analysis.
• Ability to work independently and effectively manage operations in a remote setting.
• Experience with EMR/EHR systems and healthcare IT solutions is a plus.
• Strong problem-solving and decision-making abilities.

This is a significant opportunity to lead administrative operations for a respected healthcare organization, with the advantage of a fully remote work arrangement. Join our client and make a substantial impact on healthcare delivery. The role is based in Colorado Springs, Colorado, US, but is fully remote.

**Company :**
Allegheny Health Network
**Job Description :**
**GENERAL OVERVIEW:**
Provide services to the day-to-day operating objectives of the assigned area by participating in projects and programs appropriate to the needs of the assigned area, participating in the planning and implementation of projects and initiatives and conducting research and reporting including recommendations or proposals for action.
**ESSENTIAL RESPONSIBILITIES:**
+ Display effective communication skills by interacting directly with colleagues, clientele and/or other internal or external constituencies in the planning of assignments and the resolution of day-to-day operational problems.
+ Under supervision, provide entry-level professional services as appropriate to the day-to-day operating objectives of the area. Receives guidance, training and mentoring from senior personnel in planning and carrying out activities and assignments.
+ Undertake and/or participate in projects and programs designed to develop professional skills and expertise appropriate to the needs of the organization.
+ Participate in the planning and implementation of unit projects and initiatives within area of expertise and ability.
+ As specifically requested by management, conduct research and reporting inclusive of recommendations or alternative proposals for action.
+ Undertake related studies or enrichment programs as appropriate to the specific objectives of the operating unit.
+ Perform miscellaneous job-related duties as assigned.
**QUALIFICATIONS:**
Minimum
+ **Currently enrolled in a Master of Health Sciences program.**
+ **Must be a Gannon University Student to apply.**
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at
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Req ID: J

Best 20 Associates Degree in Healthcare Administration in 2025

January 13, 2025 | Admin

An associate degree in healthcare administration is perfect for those who want a better understanding of the inner workings of a medical office to help them obtain employment in this industry. This program only takes about two years to complete and will teach graduates how to enter medical records into a database, code medical records, and other front office tasks. An associate degree in healthcare administration can be used as a stepping stone to get your foot in the door as a medical office manager professional.

Top 5 Associates Degree in Healthcare Administration

The first step in achieving this career goal is finding the right college. We have researched for you and have listed our choices for the top 20 institutions that offer this degree.

Best 20 Associates Degree in Healthcare Administration

1. Richland Community College
   
   • Graduation Rate: 46%
   • Points: 31
   
   

   The main campus of Richland Community College can be found in Decatur, Illinois, stretching across 155 acres of land. Two extension centers are also a part of this small college, allowing for more room to grow and learn academically and professionally. An Associates degree is available in Healthcare Documentation, also known as Medical Transcription. The program can be completed in three semesters and is approved by the Approval Committee for Certificate Programs, the American Health Information Management Association, and the Association for Healthcare Documentation Integrity.

2. Lanier Technical College
   
   • Location: Gainesville, Georgia
   • Graduation Rate:
   • Points:
   
   

   Ranked as #112 of 853 institutions as being one of the Best Community Colleges in America, the Gainesville, Georgia-based Lanier Technical College is a great place to begin your healthcare administration education. The Health Information Management Technology program will provide students with the knowledge needed to gain a supervisory role in the health information system industry. Some of the skills taught include processing, maintaining, analyzing, and reporting health information data based on legal, accreditation, licensure, and certification standards.

3. Keiser University
   
   • Location: Florida (multiple campuses)
   • Graduation Rate:
   • Points:
   
   

   Keiser University is a large institution with 17 campuses throughout Florida, many of which offer an Associate of Arts in Health Services Administration. Students will learn how to conduct themselves in a healthcare business setting by taking courses like physiology, marketing principles, business law, medical anatomy, and front office management. Students are required to complete 60 credit hours to earn this degree.

4. Iowa Lakes Community College
   
   • Location:
   • Graduation Rate:
   • Points:
   
   

   The Medical Office Technology Diploma from Iowa Lakes Community College will teach students how to carry out administrative and clerical tasks in a healthcare setting. Some of the skills taught include time management, appointment setting, data entry, and managing medical records and other health information. Upon completion of the program, students will have the opportunity to become a member of the Partner-Centered Medical Home team.

5. North Idaho College
   
   • Location: Coeur DAlene, Idaho
   • Graduation Rate:
   • Points:
   
   

   Located in Coeur DAlene, Idaho, North Idaho College is a small institution, but ranked number 310 out of 853 colleges as being one of the Best Community Colleges in America. One of the majors offered is an Associate of Applied Science in Medical Administrative Assistant. This program can be done on a full-time or part-time basis and will give students the knowledge to correctly use procedure and diagnostic codes, perform healthcare office tasks and procedures, and use specialized computer programs. Full-time students can complete this program in four semesters and 61-63 credits, while part-time students should be able to earn this degree in six semesters and 57-59 credits.

6. Minnesota West Community and Technical College
   
   • Location: Worthington, Minnesota
   • Graduation Rate: 45%
   • Points: 25
   
   
7. Great Falls College Montana State University
   • Graduation Rate: 25%
   • Points: 24
   
   
8. Concordia University Wisconsin
   • Location: Mequon, Wisconsin
   • Graduation Rate: 64%
   • Points: 23
   
   
9. Ultimate Medical Academy
   • Location: Clearwater, Florida
   • Points: 22
   
   
10. Central Christian College of Kansas
    • Location: McPherson, Kansas
    • Graduation Rate: 59%
    • Points: 20
    
    
11. Florida Institute of Technology
    • Location: Melbourne, Florida
    • Graduation Rate: 59%
    • Points: 19
    
    

12. Graduation Rate: 55% Points: 18

13. Columbia Southern University
    • Location: Orange Beach, Alabama
    • Graduation Rate: 22%
    • Points: 17
    
    
14. Milwaukee Area Technical College
    • Graduation Rate: 16%
    • Points: 16
    
    
15. Forest City, Iowa
    • Graduation Rate: 30%
    • Points: 15
    
    

16. Graduation Rate: 11% Points: 14

17. Point University
    • Location: West Point, Georgia
    • Graduation Rate: 28%
    • Points: 13
    
    
18. Community College of Philadelphia
    • Location: Philadelphia, Pennsylvania
    • Graduation Rate: 15%
    • Points: 11
    
    
19. New England College
    • Graduation Rate: 29%
    • Points: 10
    
    
    
    

How the Colleges Were Ranked

To determine which institution to list first and which one to list as #20, a point system was used. We began by scouring the internet in search of colleges that offered an associates degree in healthcare administration. Once a list was compiled of 20 schools, the tuition and graduation rate data was found and put into a spreadsheet. Each school was given between 1 and 20 points for tuition (20 given to the school with the lowest tuition cost) and between 1 and 20 points for graduation rates (20 given to the school with the highest graduation rate. When every college had points for these two categories, they were added together and ranked in order of the highest points to the lowest points.

Whether you would like us to correct some of the information listed in this article or would like to be included in one of our articles, please contact us and let us know.

Whether youre trying to start your career or make a big change, we can help you find the perfect school to help you reach your goals.

#J-18808-Ljbffr

**Become a part of our caring community and help us put health first**
The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
The UM Administration Coordinator 2 contributes to the administration of care management and provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and maintain optimal wellness by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.
+ The UM Administration Coordinator performs computations and varied activities with moderately complex administrative, operational, and customer support assignments.
+ The decisions are typically focused on interpretation of area/department policy and methods for completing assignments.
+ Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction.
+ Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
**Use your skills to make an impact**
**Required Qualifications**
+ Must reside in the Greater Chicago area/suburban Cook or nearby surrounding counties in the State of Illinois.
+ 2+ years of administrative support experience in the healthcare industry.
+ 1+ years of customer service experience.
+ Previous experience working with Medicaid, Long Term Care, or Medicare members.
+ Intermediate to advanced knowledge of Microsoft Office programs specifically, Word, Excel, Outlook
**Preferred Qualifications**
+ A minimum of an Associate's degree.
+ Prior billing/claims or authorization experience
+ Proficient utilizing electronic medical record and documentation programs.
+ Proficient and/or experience with medical terminology and/or ICD-10 codes.
+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
**Additional Information**
+ **Schedule:** Monday through Friday, 8:00 AM - 5:00 PM with flexibility to work overtime as needed.
+ **Work Location (Address):** Schaumburg, IL
+ **Work Style:** Hybrid Office **. Required** to work in the office at least two days per week
**Work-at-Home (WAH) Internet Statement**
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if approved by leadership.
+ Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
**Interview Format**
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$44,000 - $57,500 per year
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
**About Us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our

Huron is a global consultancy that collaborates with clients to drive strategic growth, ignite innovation and navigate constant change. Through a combination of strategy, expertise and creativity, we help clients accelerate operational, digital and cultural transformation, enabling the change they need to own their future.
Join our team as the expert you are now and create your future.
At Huron, we empower healthcare organizations to elevate their digital strategies and achieve measurable clinical and financial improvements. As a Management Consultant, you will work with a team of technical and project management consultant to support integrated initiatives that optimize Epic systems, driving sustainable, enterprise-wide transformation.
You'll collaborate with cross-functional teams and client stakeholders to deliver innovative, data-driven solutions that address complex digital challenges. Your role will be pivotal in aligning Epic capabilities, enhancing interoperability, streamlining workflows, and improving patient outcomes.
In this position, you'll cultivate trusted client relationships, mentor team members, and foster a culture of inclusion and collaboration. If you're passionate about leveraging Epic to create lasting impact and thrive in a dynamic, purpose-driven environment, Huron offers a rewarding path forward.
As an Epic Clinical Management Consultant, you will:
+ Partner with healthcare clients and stakeholders to deliver innovative, customized technical solutions ensuring alignment with strategic goals and regulatory requirements
+ Collaborate with cross-functional teams to integrate technical solutions impacting effective use of Epic systems
+ Provide insights on workflow design, upgrades, system changes and ongoing maintenance
+ Identify opportunities for system optimization and enhancements
+ Facilitate meetings effectively and efficiently with stakeholders of all levels through the development of clear agendas and objectives, documenting notes and ensuring follow-ups are tracked and completed
Requirements:
+ Bachelor's degree required or equivalent work experience
+ Current Epic Certification inEpicCare Inpatient, ClinDoc, Orders, and/or OpTime with extensive knowledge of its products and solutions
+ 5+ years of Epic experience providing Epic consulting in hospitals and healthcare systems
+ Project management and experience with Epic implementations
+ Current permanent U.S. Work authorization required
+ Willingness to travel to client sites as needed
**Position Level**
Consultant
**Country**
United States of America
At Huron, we're redefining what a consulting organization can be. We go beyond advice to deliver results that last. We inherit our client's challenges as if they were our own. We help them transform for the future. We advocate. We make a difference. And we intelligently, passionately, relentlessly do great work.together.
Are you the kind of person who stands ready to jump in, roll up your sleeves and transform ideas into action? Then come discover Huron.
Whether you have years of experience or come right out of college, we invite you to explore our many opportunities. Find out how you can use your talents and develop your skills to make an impact immediately. Learn about how our culture and values provide you with the kind of environment that invites new ideas and innovation. Come see how we collaborate with each other in a culture of learning, coaching, diversity and inclusion. And hear about our unwavering commitment to make a difference in partnership with our clients, shareholders, communities and colleagues.
Huron Consulting Group offers a competitive compensation and benefits package including medical, dental, and vision coverage to employees and dependents; a 401(k) plan with a generous employer match; an employee stock purchase plan; a generous Paid Time Off policy; and paid parental leave and adoption assistance. Our Wellness Program supports employee total well-being by providing free annual health screenings and coaching, bank at work, and on-site workshops, as well as ongoing programs recognizing major events in the lives of our employees throughout the year. All benefits and programs are subject to applicable eligibility requirements.
Huron is fully committed to providing equal employment opportunity to job applicants and employees in recruitment, hiring, employment, compensation, benefits, promotions, transfers, training, and all other terms and conditions of employment. Huron will not discriminate on the basis of age, race, color, gender, marital status, sexual orientation, gender identity, pregnancy, national origin, religion, veteran status, physical or mental disability, genetic information, creed, citizenship or any other status protected by laws or regulations in the locations where we do business. We endeavor to maintain a drug-free workplace.

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.
**_*** Qualified candidate must reside in the state of Delaware. This is a remote role with up to 40% field based work.***_**
**Position Purpose:** Supervises the care coordination team that serves long-term care members with physical/medical health needs and/or behavioral/mental health needs to promote quality and efficacy of care management delivery. Supervises day-to-day escalations and care management issues related to members or providers.
+ Monitors and reviews long-term care management required documentation to maintain and ensure compliance with federal and state regulations and contractual agreements
+ Assigns caseloads and work assignments to long-term care management team based on state requirements, care management staff experience, and member needs
+ Works with long-term care senior management on escalated and complex care cases related to physical and/or behavioral health, and provides guidance to junior team members to address member concerns
+ Educates and provides resources for long-term care management team on key initiatives and member outreach to facilitate on-going communication between care management team, members, and providers
+ Evaluates long-term care management team performance and provides feedback regarding performance, goals, and career milestones
+ Provides coaching and guidance to long-term care management team and providers to ensure members are receiving high quality care and information regarding service / care plan options, procedures, referrals, and healthcare benefits
+ Monitors and review reports on a regular basis ensuring quality and productivity metrics are met and for case assignments, and may perform audits of staff on a regular basis
+ May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources
+ Assists with onboarding, hiring, and training long-term care management team members
+ Leads and champions change within scope of responsibility
+ Performs other duties as assigned
+ Complies with all policies and standards
**Education/Experience:** Positions overseeing RN team members: Requires Graduate from an Accredited School of Nursing or a Bachelor's degree and 4+ years of related experience Or,
Positions overseeing BH team members: Requires a Master's degree or Graduate from an Accredited School of Nursing and 4+ years of related experience.
Highly advanced clinical knowledge and ability to assess member needs in context of relevant diagnoses, treatment plans and goals, and identify potential gaps in care or risks for readmission or complications preferred.
Strong knowledge of healthcare managed care principles preferred.
Experience working with providers and healthcare teams to develop appropriate long-term care plans/service plans preferred.
Strong knowledge of medication indications and side effects and/or knowledge of BH care management principles preferred preferred.
**License/Certification:**
+ Positions overseeing RN team members: Current state's Registered Nurse (RN) license Upon Hire required or
+ Positions overseeing BH team members: Licensed Clinical Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, and RN with BH experience required Upon Hire required
Pay Range: $85,300.00 - $158,100.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

The Clinical Care Management Specialist/Integrated Care Specialist provides clinical recommendations and collaborative support to team members and physical health care staff involved in the Integrated Care Plan (ICP) Program. The Clinical Care Management Specialist reviews clinical information using a holistic care framework, makes recommendations for appropriate levels of care, creates Integrated Care Plans and coordinates services for individuals referred to the ICP team.

Essential Functions :

• CCMS will travel amongst the identified community partnership sites and participate in case information sharing as scheduled.
• CCMS will develop a schedule with each practice site, PH MCO and CBH team staff for onsite visits to consent members for participation in the Integrated Care Plan Program, share released information with the PH MCO and discuss case recommendations with the appropriate internal staff.
• CCMS will complete Integrated Care Plans as outlined by the policies and regulations of CBH and the state.
• CCMS will create Integrated Care Plans for members referred from community partners, internal referrals for ICP development and for members who meet appropriate criteria for ICP planning.
• During the case collaborations with sites and PH MCO's, CCMS will provide behavioral health treatment utilization and develop care plans tailored to the individual's current needs as part of the treatment team.
• CCMS will coordinate with internal CBH staff to ensure communication and collaboration is clear and the individual's developed care plan is carried out as such.
• CCMS will participate in the problem solving process and provide information on additional community resources as needed.
• CCMS will do utilization review as necessary for assigned members, implementing medical necessity criteria to inform level of care determinations.
• CCMS will document and track their interventions and share data internally and with associated partner's, like PH MCO's and community partnership sites.

Position Requirements:

• Education: Master's degree in Social Work or related field
• Clinical Licensure: Qualified candidates are required to obtain license within the first 18 months (1.5 years) of employment; PA Child Abuse Clearance required
• Required Licensure: Licensed Social Worker (LSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW)
• Relevant Work Experience: Minimum of 3 years of direct clinical care experience working with adults in behavioral health or physical health settings; experience in assessment and treatment planning and/or experience in a managed care setting. Must possess knowledge of evidence-based treatment for behavioral health challenges to make appropriate referrals for care.

Skills:

• Ability to work collaboratively with cross-system partners
• Excellent verbal and written communication skills and ability to interact with broad range of individuals
• Strong mediation skills
• Computer proficiency and ability to type at least 20 words per minute
• Ability to work independently in fast-paced environment
• Compliant with HIPAA regulations

Work Conditions (including travel, overtime required, physical requirements and occupational exposure):

• This position spends the majority of time in the field and requires travel within Philadelphia and surrounding counties.
• Regularly requires walking, standing, stooping, bending, sitting, reaching, pushing, pulling and/or repetitive wrist/hand movements for various lengths of time throughout the day.
• Ability to utilize computers and office equipment to complete daily work responsibilities.
• Requires continuous, normal hearing and vision.
• Regularly works inside in areas that are adequately lighted and ventilated. Some fluctuation in temperature. No protective equipment routinely needed.
• Must be able to adapt to continuous changes/demands of the job.

Philadelphia Residency Requirement:

• The successful candidate must be a current Philadelphia resident or become a resident within six months of hire.

Equal Employment Opportunity:

• We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CBH is an equal opportunity employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on all qualified individuals. This is without regard to race, ethnicity, creed, color, religion, national origin, age, sex/gender, marital status, gender identity, sexual orientation, gender identity or expression, disability, protected veteran status, genetic information or any other characteristic protected individual genetic information, or non-disqualifying physical or mental handicap or disability in each aspect of the human resources function by applicable federal, state, or local law.

Requesting An Accommodation:

• CBH is committed to providing equal employment opportunities for individuals with disabilities or religious observance, including reasonable accommodation when needed. If you are hired by CBH and require an accommodation to perform the essential functions of your role, you will be asked to participate in our accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodation once hired.
• If you would like to be considered for employment opportunities with CBH and have accommodation needs for a disability or religious observance, please send us an email at