MGR, Clinical Care Services
Bridgewater MA 02324 One Lakeshore Center
Job DescriptionResponsible 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
TitleMGR, Clinical Care Services
Job FamilyClinical Services Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date2/4/2020
Date Requisition Created2/4/2020
Work ExperienceManaged Healthcare, Supervisory, UAS (Uniform Assessment System)
EducationBachelors: Nursing (Required), Masters: Nursing
License and Certifications - RequiredBCBA - 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
- 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.”