Manager, Clinical Care Services

Cambridge MA 02141 58 Charles Street

Job Description

THIS POSITION DOES HAVE SOME REMOTE OPPORTUNITY .. TRAINING WILL BE IN BRIDGEWATER AND ONSITE REQUIREMENTS WILL BE IN CAMBRIDGE.

Responsible for the management, direct supervision and coordination of clinical and/or nonclinical management staff, including utilization management and intensive care management staff, providing expertise in designated programs.
  • Assists clinical management in the development and on-going management of designated staff.
  • Performs care management review activities consistent with Magellan policies, procedures, and standards.
  • Conducts recruitment, interviewing, and selection of properly qualified staff members and ensures appropriate orientation is provided.
  • Regularly monitors the performance of care management staff.  Monitors adherence to the efficiency goals for all staff including case volume, case closure rates, average handle time and other metrics.
  • Supervises care management staff through approved audit processes including performing annual reviews and provides counseling and disciplinary action as necessary.
  • Coordinates quality improvement activities under the direction of clinical management.
  • Assists management in the development of strategic and operational goals and plans.
  • Assists management in the identification and coordination of the necessary clinical and client service training needs.
  • Analyzes specific utilization problems, plans and implements solutions that directly influence quality of care and cost efficiency.
  • Supervises the collection of pertinent clinical information while maintaining a good rapport and relationship with providers.

General Job Information

Title

Manager, Clinical Care Services

Grade

27

Job Family

Clinical Services Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

1/24/2020

Date Requisition Created

1/24/2020

Work Experience

Managed Healthcare, Supervisory, UAS (Uniform Assessment System)

Education

Bachelors: Nursing (Required), Masters: Nursing

License and Certifications - Required

BCBA - Board Certified Behavior Analyst - Care Mgmt, Current licensure required for this position that meets State, Commonwealth or customer-specific requirements - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, LMFT - Licensed Marital and Family Therapist - Care Mgmt, LMHC - Licensed Mental Health Counselor - Care Mgmt, LMSW - Licensed Master Social Worker - Care Mgmt, LPCC - Licensed Professional Clinical Counselor - Care Mgmt, LPC - Licensed Professional Counselor - Care Mgmt, PC - Professional Counselor - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt

License and Certifications - Preferred

Other Job Requirements

Responsibilities

  • Experience in delivering Semi-Annual Assessment of Members (SAMM) and UAS assessments.
  • Understanding of the UAS assessment and the underlying development and expected understanding meant in completing the UAS assessment.
  • Knowledge of UAS-NY assessments and the system, managed care, Medicare, Medicaid, mental health and substance abuse, community resources and providers.
  • Ability to function independently and as a team member.
  • Strong organization, time management and communication skills.
  • Familiarity with ICD10, CPT4 and DSM IV or most current diagnostic edition(s).
  • Proficient in MS Office Suite.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.

“I receive a high level of support from our Senior Management Team to execute on our vision. They are always accessible and approachable, something I’ve found to be very unique to Magellan.”

Haita Makanji VP of Clinical Strategy and Programs at Magellan MRx