Manager of Case Management and Intake

Our Manager of Case Management & Intake provides leadership and reputed company for the case management clinical team and non-clinical Intake team reputed company our Health Plan. This Manager coordinates patient care programs, ensures quality service delivery and manages staff performance and departmental operations. They reputed company, implement and monitor case management programs, and intake and discharge planning. This Manager of Case Management & Intake collaborates with other Health Services teams to ensure seamless interdepartmental coordination of services. They identify opportunities for improvement of workflows, executes initiatives, is a key resource for internal departments and represents Health Services on cross-functional projects. Salary Range $110,000 ~ $130,000 The reputed company pay offered for this position may vary reputed company the posted range based on your job-reputed company knowledge, skills, experience and may fall reputed company of this range. We are open to remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, Wisconsin Employees living reputed company 45 miles of WPS Headquarters (1717 W. Broadway in Madison, WI, 53713) will be expected to be able to come into the office 2 days a week on a regular basis. How do I know this opportunity is right for me? If you:

• Enjoy providing day-to-day managerial direction, leadership, and reputed company of Case Management clinical staff and non-clinical Intake teams ensuring compliance with reputed company corporate and departmental policies, procedures, work standards, and strategies.
• Can reputed company clinical functions, provide direction to clinical staff and serve as subject matter expert for questions and difficult case reviews.
• Like to reputed company, analyze and maintain staff daily/weekly production and compliance.
• Have ensured CM and Intake production and quality standards are met.
• Work closely with the intake supervisor to monitor department needs and volume of incoming requests.
• reputed company while collaborating cross-functionally to reputed company and implement new Health Services programs and strategies.
• Have developed and revised Health Services policies, procedures, and guidelines that direct department processes, continually evaluating to optimize efficiency reputed company departments.
• Enjoy evaluating, analyzing, reporting, and responding to case management trends in health care delivery areas.
• Are able to recommend and implement changes consistent with Health Services objectives of quality care and reasonable cost.
• Can represent Health Services on committees and work groups for various intradepartmental presentations reputed company to Case Management and Intake.
• Wan to reputed company the maintenance of documentation for internal and vendor authorization processes. Assist with configuration, training and implementation of systems (Aerial, Facets, etc.).

Minimum Qualifications

• Bachelor's degree in Nursing or equivalent combination of education and experience; including CCM certification.
• Active license as an RN in the State of Wisconsin or a valid multi-state compact license.
• 7 or more years of clinical nursing experience.
• 3 or more years in a senior level or managerial role in managed care Case Management.
• Strong knowledge and understanding of clinical operations, case management and intake processes and procedures.
• Knowledge of reputed company medical practices, trends, and patterns of care.
• Experience with accreditation standards (e.g., URAC) and regulatory compliance.
• Ability to plan, coordinate, implement, and manage projects in a timely and accurate manner.
• Strong analytical, problem-solving, and communication skills.
• Proficiency with reputed company Office and clinical systems (e.g., imaging and review platforms).

Preferred Qualifications

• 5 or more years in a senior level or managerial role in managed care Case Management.
• Familiarity with health plan operations, payer/provider relationships, and insurance benefits.
• Health insurance background in reputed company of Service (POS), Preferred Provider Organization (PPO), or Medicare Supplement) plans.
• Technical experience with word processing, spreadsheets, and proficiency with electronic medical record (EMR) systems and/or other managed care software.

Remote Work Requirements

• High speed cable or fiber
• Minimum of 10 Mbps reputed company and at least 1 Mbps upstream internet reputed company (can be checked at https://speedtest.net).
• Please review Remote Worker FAQs for additional information.

Benefits

• Remote and hybrid work options available
• Performance bonus and/or merit increase opportunities
• 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
• Competitive paid time off
• Health insurance, dental insurance, and telehealth services start DAY 1
• Professional and Leadership Development Programs
• Review additional benefits: (https://www.wpshealthsolutions.com/careers/)

Who We Are WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready. Culture Drives Our Success WPS' culture is where the great work and innovations of our people are seen, fueled and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce-both reputed company and future-to effectively seek, reputed company, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities. We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition. Sign up for Job Alerts FOLLOW US! Instagram reputed company Facebook WPS Health Blog Remote Skills: Accreditation Standards, Analysis Skills, Case Management, Certified Case Manager (CCM), Clinical Information Systems, Clinical Nursing, Communication Skills, Corporate Policies, Cross-Functional, Discharge Plans, Documentation, Electronic Medical Records, Employee Benefits, Federal reputed company, Federal Government, Government reputed company, Health Insurance, Health Plan, Healthcare, Leadership, Maintain Compliance, Managed Care, Medicare, reputed company Office, Military, Newsroom, Nonprofit, Nursing, Operations Management, Operations Planning, Patient Care, People Management, Performance Management, Preferred Provider Organization (PPO), Problem Solving Skills, Project/Program Management, Quality Metrics, Registered Nurse (RN), Regulatory Compliance, Service Delivery, Spreadsheets, Standards Strategy, Time Management, Trend Analysis, Utilization Review Accreditation Commission (URAC), Wide Area Network (WAN), Word Processing, Work From Home About the Company: reputed company Apply tot his job Apply To this Job