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Manager of Care Management

The Manager of Care Management is responsible for managing the day to day operation of the Care Management teams, including hiring, scheduling, coaching, development and evaluation of employee performance. In addition to the day to day responsibilities, the Manager will work in conjunction with the Director of Care Management on a variety of critical tasks including the management of one or more focused clinical initiatives.

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Recent Job Openings

Temp HEDIS RN Medical Record Reviewer - Manchester, NH
Description: Job Description Optimize the Plan’s HEDIS scores to maintain NCQA Accreditation Status and Health Plan ranking placement by supplementing administrative scores by medical record review scores. Measurement is used to support regulatory goals, provider profiles and incentive programs. Provides accurate assessment of BMCHP’s contracted provider performance against NCQA HEDIS technical specifications. Key Functi...
Reference Code: 2012717
Temp HEDIS RN Medical Record Reviewer - Boston, MA
Description: Job Description Optimize the Plan’s HEDIS scores to maintain NCQA Accreditation Status and Health Plan ranking placement by supplementing administrative scores by medical record review scores. Measurement is used to support regulatory goals, provider profiles and incentive programs. Provides accurate assessment of BMCHP’s contracted provider performance against NCQA HEDIS technical specifications. Key Functi...
Reference Code: 2012718
Investigator Special Investigations Unit - Boston, MA
Description: Job Description Job Summary: The Investigator, Special Investigations Unit (SIU) is a key contributor to the Plan’s member and provider fraud, waste, and abuse (FWA) detection, investigation, remediation, and prevention efforts. The Investigator utilizes preliminary recommendations provided by the SIU Data Analyst to develop, conduct, resolve, document, and report on investigations of tips, allegations, or data min...
Reference Code: 2012723
Operations Jobs at BMC HealthNet Plan and Well Sense