Centene Corporation Manager, Case Management (Long Term Care) in Waterloo, Iowa

Pipeline - GeneralOversee the workflow and day-to-day operations of the case management function Review analyzes of activities, costs, operations and forecast data to determine progress toward stated goals and statistical/financial purposes for case management Ensure compliance with federal and state regulations and contractual agreements Develop, implement and maintain compliance with policies and procedures regarding medical and social case management Develop, implement, and maintain case management programs to facilitate the use of appropriate medical and community resources and decrease health plan financial exposure Ensure proper coordination and communication of medical service functions with other departmental functions at the business as assigned.Bachelor-s degree in nursing, social work or equivalent experience. 3+ years of case management experience. Supervisory or lead experience preferred.Thorough knowledge of utilization management.Familiarity with Medicaid and Medicare managed care practices and policies, Children-s Health Insurance Program (CHIP), and State Children's Health Insurance Program (SCHIP).

TITLE: Manager, Case Management (Long Term Care)

LOCATION: Waterloo, Iowa


COMPANY: Clinical & Nursing