Manager, Case Management Resume Sample
Anabelle Sipes
9763 Heathcote Orchard,
San Francisco,
CA
+1 (555) 945 4438
Work Experience
Manager, Case Management
05/2016
-
PRESENT
New York, NY
- Maintains current knowledge of case management topics and acts as the unit’s subject matter expert (SME) on case management at department and company meetings
- Demonstrates and promotes Plaza Medical Center of Fort Worth’s Mission and Values philosophies
- Assists in developing the department’s goals/objectives in concert with the hospital mission, vision and values; educates staff to the goals/ objectives and provides periodic feedback as to the success in meeting these
- Prepares and presents pertinent data to the Case Management committee (i.e. targeted DRG’s by LOS and cost/case, pertinent payment/resource issues, etc.)
- Unrestricted RN license in Alabama
- Recent nursing experience in an acute care setting particularly in medical/surgical, pediatrics, or obstetrics or care coordination in a behavioral health setting and management experience
- Strong knowledge of FDA and international adverse event reporting regulations per ICH guidelines and the ability to interpret and apply applicable regulations to resolve issues
- Proficiency in standard desktop software programs (Word, Excel,
Manager Case Management
02/2013
-
03/2016
Chicago, IL
- Experience with preparation of investigational reports, postmarketingregulatory reports and transmission of E2B reports is required
- Flexibility to work outside of normal working hours or on-call arrangements
- Obtains, analyzes and disseminates data relevant to patient flow and utilization review
- Ensure that the team receives adequate education and supplies to manage their workflow
- Serves on or leads committees and team that support patient flow, regulatory compliance and any other area relevant to Case Management
- Collaborates with the department director to develop goals and objectives for area(s) of responsibility which are aligned with foundation strategic plan and/or organizational goals
- Establishes key performance indicators utilizing industry or historical benchmarks; develops and implements a continuous quality improvement plan designed to improve performance
- Is accountable for customer relations within area(s) or responsibility, including the appearance of the department and the manner in which staff communicate with patients, families, physicians, volunteers and other employees
- Ensures departmental compliance with regulations, statutes and other applicable laws regarding operation and record retention
Manager, Case Management, Sacramento
06/2008
-
12/2012
New York, NY
- Maintains patient satisfaction scores consistent with the organizational goal
- Facilitates growth and development of staff, including opportunities to learn new skills and advance both personally and professionally; ensures staff completion of required competencies and review of key policies and procedures
- Provides oversight for the entire Case Management/Social Services Department
- Monitors, evaluates and counsels departmental personnel regarding their performance on a consistent and regular basis between formal performance evaluations; prepares and maintains adequate documentation to support any progressive corrective action
- Motivates employees to work productively in the work team
- Encourages employee participation in problem resolution activities
- In accordance with LFH Human Resources department, develops a succession plan including a career opportunities for advancement to the next level for department staff
Education
Strayer University - Center City Campus
2003 - 2007
Bachelor's Degree in Nursing
Professional Skills
- Project management, organizational skills, and prioritization skills required
- Excellent communication, interpersonal, strong organizational, problem solving, decision-making, and technical skills
- Strong problem-solving skills and the ability to make independent decisions
- Excellent oral/written communications and organizational skills Sensitivity to intercultural relations
- Team building skills with accountability to team
- Clinical (nursing or behavioral health) experience strongly desired
- General PC skills and knowledge of Case Management/ Utilization Management software packages
How to write Manager, Case Management Resume
Manager, Case Management role is responsible for reporting, health, travel, finance, credit, training, auditing, compensation, design, research.
To write great resume for manager, case management job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Manager, Case Management Resume
The section contact information is important in your manager, case management resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Manager, Case Management Resume
The section work experience is an essential part of your manager, case management resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous manager, case management responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular manager, case management position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Manager, Case Management resume experience can include:
- Assists Director with preparing operating and capital budgets designed to meet individual, departmental and organizational strategies and goals; recommends and implements new initiatives and improvements to existing programs
- Responsible for continually innovating effective order management and scheduling processes through the DMAIC process
- Ensures effective staffing of the department. Develops and monitors schedules appropriately
- · Three years of recent acute hospital experience required
- Assesses, plans, facilitates and advocates options and services to meet a patient’s health needs and to promote cost-effective outcomes
- Ensures cost-effective care through utilization management and care coordination
Education on a Manager, Case Management Resume
Make sure to make education a priority on your manager, case management resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your manager, case management experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Manager, Case Management Resume
When listing skills on your manager, case management resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical manager, case management skills:
- Experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
- Demonstrated ability to work effectively in vertically-matrix organization
- Demonstrated experience leading teams to success, including hiring, onboarding, coaching, and performance improvement of direct reports
- Coordinate effectively various functions and activities for maximum cooperation and efficiency
- Receive and effectively react to day-to-day problems presented by staff as well as others
- Effectively negotiate with internal and external service providers
List of Typical Experience For a Manager, Case Management Resume
1
Experience For Manager Case Management Resume
- Excelled human relations and oral / written communication skills
- Collaborates with nursing and other department directors to ensure patient safety on discharge and effective utilization
- Basic level of experience with Microsoft Word, with the ability to navigate a Window environment
- Previous administrative experience in hospital administration or specialty field
- Management experience in a hospital / health care environment
- Partnering with Assistant Director's and Director in conducting leadership rounds to support workflow and staff engagement
2
Experience For Manager / Case Management Resume
- Working knowledge of Amisys and Facets UM, CM, and appeals processes
- Analyzes focus study trends, processes and other issues surrounding Chargemaster Referrals communicating issues with affected Department managers/directors
- In collaboration with the Assistant Directors and Human Resources,manages the recruitment, hiring, onboarding and retention of Case Management Department staff
- Competent in Requisition management, PeopleSoft reporting, Kronos/Visionware, and financial programs needed for management of departments
- Maintains staffing levels consistent with benchmarks and productivity data available through professional associations
- Develops an appropriate staffing plan for the Case Management Departments based on established industry metrics
- Works with clinical departments to ensure that correct CPT codes are used when checking for medical necessity
3
Experience For Manager, Case Management, Sacramento Resume
- Develops and maintains a proactive communication matrix with identifiable problem-solving feedback loops with other directors and managers
- Attends and contributes to the Utilization Management Committee meeting
- Ensures compliance with licensure and certification requirements of new and existing employees
- Manages staffing and resources to comply with turn around time standards
- Conducts extensive research and provides written detailed reports when requested by accounts, legislative inquiries, underwriting, etc
- Participates in hiring, development, and maintenance of a competent, productive and quality conscious staff
4
Experience For Manager, Case Management Case Management Resume
- With Director, develops budget and ensures staffing and other expenses are within budget
- When necessitated by low staffing levels, works performs case manager functions
- Provides assistance in handling problems with injured workers, clients, employers, internal and external customers as needed
- Monitors financial performance versus budget; prepares monthly written reports and explains variances
- Ensures that payroll and accounts payable invoices are reviewed, approved, coded and processed in accordance with fiscal policies and procedures
- Collaborates with other managers and directors in the hospital to continually improve patient flow and satisfaction
- Trains and supervises department staff on medical necessity and order management
- Educates staff in changes in regulatory guidelines
- Creates, interprets and explains reports on operations data such as accuracy, scheduled events, volumes, wait times and trends
5
Experience For Case Manager / Case Management / Days Resume
- Oversight of outpatient denial management process
- Analyzes data for Advanced Beneficiary Notice (ABN)/waivers issued, walk-ins, Chargemaster referrals worked, and Infusions managed and reports monthly to Director
- Supervises process for checking medical necessity and insurance pre-certification/pre-determination for all infusion orders and communication approval back to Infusion Department
- Educates staff so they are proficient in coding software to ensure proper CPT and ICD codes are used to run medical necessity checks and pre-certification/pre-determination for commercial payers
- Along with director, functions as a third level reviewer, collaborating with HIM, Coding, and physicians to maximize Coding and Documentation Assurance
- · Ensure patient functioning and emotional well-being
- Additional Functions Serves as a resource for physician offices regarding regulatory standards, policies and procedures for outpatient orders
- · Assure appropriate utilization of hospital services and regulatory compliance related to utilization and discharge planning
6
Experience For VP, Senior Manager Case Management Resume
- Manages physician query process for medical necessity along with director
- Serves as a resource for Registration, Scheduling, and Clinical Departments for order completeness, policies and procedures for outpatient orders, medical necessity issues, and regulatory standards
- Covers for the inpatient case manager as needed including all job requirements of the inpatient Case Manager
- Serves as a preceptor for the OMU and Case Management Departments
- Serves and leads on hospital-wide teams for process and quality improvement initiatives
- Program developments and management of such programs
- · Provide continued access to services and resources in the community
- · Maintain patient flow and throughput
- · MSW or BSN
7
Experience For Manager, Case Management Resume
- Maintains department employee files within the Case Management department to include but not limited to competencies, new employee orientation checklist, equipment checklist, in-service
- Functions as a departmental subject matter expert
- Development and oversight of CM and CSW work schedules/calendar management via API in accordance with the PTO policy
- Ensure adherence to all Case Management Department and DUHS organizational policies
- Ensures adherence to regulatory compliance
- Promotes an environment of interdepartmental, health system and post-acute care collaboration
- Collaboration with CSU leadership on continuous process improvement activities
- In conjunction with the Administrative Director, maintains employee Human Resource and secondary files in accordance to Joint Commission and DUHS guidelines
- Provides education to support regulatory compliance in collaboration with DUHS Compliance and CM Department leadership
8
Experience For Manager Case Management Resume
- Conducts Case Management team meetings
- Participates in monthly CM/CSW Divisional Meetings
- Provide education and feedback to provider groups as indicated
- Monitors monthly reporting including but not limited to CM productivity, Readmission Documentation, Initial Time to Assessment,Avoidable Days Documentation, Important Message from Medicare Compliance and Discharge Appeals processes
- Collaborates with the Assistant Director regarding outcomes
- Works with the Physician Advisors and Medical Directors on escalation of care and process improvement activities including but not limited to LOSM, readmissions, avoidable days, denial management, problem solving and education needs
9
Experience For Manager / Case Management Resume
- Participates in the review and updating of Case Management policies
- Escalates and keeps Assistant Director/Director informed of workflow or personnel concerns
- Completion of RN Diploma program or related health care program from accredited program, college or university required
- Current FL RN license required or appropriate compact licensure
- Supervises, coaches and mentors field based care managers
- Evaluates work performance of case manager in collaboration with the Director
- Compiles reports as appropriate
- Ensures compliance with applicable federal guidelines
- Represents the department on assigned hospital committees
10
Experience For Manager, Case Management, Sacramento Resume
- Accountable for establishing a patient-centered culture of doing ‘whatever it takes’ to improve patient health and achieving care management and engagement goals, including process and performance metrics
- Ensure appropriate 24/7 coverage and that care management & engagement activities meet internal compliance, quality, and operational standards
- Lead holistic engagement & care management across the continuum of care from initial outreach and relationship development, care planning, and follow-up alongside team members, patients, and other community resources to change the trajectory of outcomes
- Highly organized and able to build structure for others; passion for clinical and operational excellence and continuous process improvement to enhance efficiency and effectiveness of care management & engagement
- Effectively manage the care management & engagement team: care coordinators, community engagement managers, and community health workers by creating appropriate planning and analyzing variances from care plans, while initiating the appropriate steps to resolve variances across patients and team members
- Support Regional Medical Officer and General Manager in monitoring clinical, financial, and operational outcomes, and drive data-driven design & execution of care management & engagement initiatives to improve performance
- Own and drive local market training and auditing, in concert with CareMore Center of Excellence (center for program design & fidelity) and Academy (center for learning & development)
List of Typical Skills For a Manager, Case Management Resume
1
Skills For Manager Case Management Resume
- Healthcare experience to include experience in a managed care setting, hospital setting and / or physician practice setting required
- Deal effectively and efficiently with physicians, patients and associates
- Managerial experience or 2+ years’ of case management experience in case in acute care, home care or managed care
- Demonstrated supervisory or management experience with responsibility for team performance management
- Five years current clinical experience 3 years supervisory experience
- Experience coaching or mentoring staff
2
Skills For Manager / Case Management Resume
- Clinical experience to include one or more of the following: Case Manager, Care Coordinator, Care Facilitation, and Discharge Planning
- Demonstrate understanding of quality improvement at departmental and network level
- Demonstrated ability to consistently exercise sound judgement and initiative in all circumstances, including very stressful situations
- Clinical management experience overseeing a staff of 10 or more
- Previous managerial experience in a hospital, clinic or other related healthcare setting
- Demonstrated ability to lead culture change within a group through positive personal influence, including the willingness to lead change proactively
3
Skills For Manager, Case Management, Sacramento Resume
- Five years of Case Management experience in an acute care setting
- With progressive experience in care management to include discharge planning and utilization review
- Case Management experience in a Managed Care setting required
- Two years of management experience in an acute care setting
- Identify, select, structure and prioritize process improvement projects, ultimately implementing changes to meet program requirements
- Set priorities, coordinate multiple tasks, and maintain controls of workflow
- PC proficiency and experience with care management workflow systems,such as Canopy
- Analyze data and employ approved management techniques and statistical tools to obtain maximum effectiveness, efficiency, and information
4
Skills For Manager, Case Management Case Management Resume
- Direct, instruct and advise staff in the approved methods,procedures and practices employed in effective health care administration
- Establish priorities, meet deadlines, develop and manage the department's productivity standard in the management of the work assignment
- Relevant health care experience, preferably in managed and/or long-term care
- Clinical experience required
- Provide effective leadership to the case management team members
- Experience in the social services needs of behavioral health patients
5
Skills For Case Manager / Case Management / Days Resume
- Demonstrated ability to lead staff and daily operations
- Leadership, service line or program experience
- Managerial/supervisory experience with direct reports
- Previous workers compensation experience
- Multi-state workers compensation experience
6
Skills For VP, Senior Manager Case Management Resume
- Managerial/supervisory experience with direct reports
- Two years of supervisory or management experience
- Clinical experience as a Registered Nurse or Social Worker
- Case Management experience in a leadership role
- BSN or BA in health care related field OR four (4) years of experience in a directly related field required
- Frequent experience presenting to high-level management and/or external constituents required
- Experience in case management
- More than five up to eight years of related work experience
- Working knowledge of Medicaid/Medicare regulations
7
Skills For Manager, Case Management Resume
- Running various reports via Excel and Microsoft Word
- CM Supervisor is responsible for assisting CM Director with some ‘24/7’ coverage, including filling in for Director’s time off
- Responsible for managing CM functions of members traveling in or living in other states for national accounts and administration of the BlueCard program
- Basic to intermediate level of proficiency using a PC in a Windows environment, including Microsoft Word
- Conduct team meetings, field-based shadowing of team members, caseload auditing and implement performance improvement plans
- Assists in developing and implementing the Utilization Plan, departmental goals, and departmental policies and procedures
- Support employee education by verifying and monitoring employee progress
8
Skills For Manager Case Management Resume
- Promotes departmental shared governance process to include ongoing support through consultation and assistance in eliminating barriers
- Ensures standardized execution of workflow processes, including conducting performance audits, quality reviews, and compliance adherence
- Thorough knowledge of health benefit and the administrative services performed in the processing of health benefit claims
- Current RN licensure from the Maine State Board of Nursing
- Knowledge of practices and regulations regarding patient care
- Registered Nursing license issued by the State of Illinois or Licensed Clinical Social Worker in the state of Illinois (LCSW)
- Ensures appropriate case management staffing
- Build and lead care management & engagement for a large clinical enterprise caring for complex medical and BH patients
9
Skills For Manager / Case Management Resume
- Develop subsystem processes (i.e., Facets, Amisys) to capture key elements for reporting purposes
- Overall responsibility for clinical reviews and reports for the Division of Underwriting
- Proactively develops and updates process improvement plans for internal and external customers, including account management
- Communicates with administration and medical staff in matters related to appropriateness of hospital admissions, discharge planning, and length of stay
- Promotes ongoing development of staff
- Oversees all utilization management and discharge planning functions of MetroWest Medical Center
- In order to meet the unique needs of our members, have an intimate understanding of the contractual requirements
10
Skills For Manager, Case Management, Sacramento Resume
- Provides guidance and assistance to the staff while promoting departmental goals
- Establish rapport with a diverse group of individuals
- Open to change and willingness to try new approaches
- Support the growth and development of team leaders
- Manage and implement departmental programs and goals that support the strategic plan for the organization and for patient care services
List of Typical Responsibilities For a Manager, Case Management Resume
1
Responsibilities For Manager Case Management Resume
- “Roll-up your sleeves” attitude and ability to work in a start-up environment, including the ability to lead within ambiguous settings; strong team building, leadership, and communication skills; internal motivation and drive; and track record of delivering results
- Develop and manage relationships and shared work with health plan (Anthem/Amerigroup, others) and community partners (hospitals, ERs, SNFs, clinics) to improve effectiveness of engagement & care management
- Responsible for communication and mentoring members of the care coordination team to ensure long-term and home and community base d care guidelines, policies and procedures are followed
- Responsible for process improvement, quality assurance, and adherence to appropriate medical policy, care management best practices, relevant clinical standards, and member contract
- Lead or supervisory experience to include mentoring and/or leadership development
- Experience with care coordination, discharge planning, clinical documentation and Utilization review
- Clinical Interqual experience
- Ensure compliance with the standards set by URAC, EQRO, TennCare Bureau, NCQA, FEP, Medicare, and other regulatory and accrediting bodies
- Department. i.e. avoidable day reports; readmission reports; utilization review reports, ALOS (facility and unit specific reporting)
2
Responsibilities For Manager / Case Management Resume
- Supports the Utilization Review function within the Medical Records committee reporting structure
- Interpret established policies into operating procedures and to execute case management programs
- Administer Case Management programs
- Responsible for all lines of business: BlueCare; TennCare Select
- Administers productivity levels that have been established for all Case Management, Disease Management, Transplant Case Management, and Case Management support staff
- Reviews productivity standards quarterly, and continuously increases them as system upgrades accelerate the case management efficiencies
- Administers quality standards that have been established for all Case Management, Disease Management, Transplant Case Management, and support staff
3
Responsibilities For Manager, Case Management, Sacramento Resume
- Internal customer education, consultation, and problem resolution and prevention
- External customer education, consultation, problem resolution, and prevention
- Regular meetings with representatives from employer groups. Proactively seeks face to face interaction with large account representatives to establish good working relationships and prevent communication barriers
- Actively participates in regularly scheduled (monthly or quarterly, depending on facility) meetings with Case Management department heads, Medical Directors, Chief Financial Officers, Chief Executive Officers, Directors, and Vice Presidents
- Discusses problems and issues with members to find appropriate resolution
- Claims and Customer Service interfaces include designing and overseeing the implementation of new processes to assure that case management authorization entries contribute to a high first pass rate for claims. Identifies and directs changes to increase claims processing accuracy
4
Responsibilities For Manager, Case Management Case Management Resume
- Work closely with Medical Management Education and Support management team to promote consistency and accuracy in all CM processes
- Identify employee education needs and provide needed information for development of education programs
- Partners with the Medical Management training area to provide support and direction when adhoc training needs are identified (i.e., sudden increases in membership)
- Support on targeted areas for increased education
- Identification of quality indicators and measurement for audits
- Knowledgeable of other Amisys and Facets claims, membership and provider subsystems
- Clinical expert evaluation and consultation for legal, political and re-insurance purposes
5
Responsibilities For Case Manager / Case Management / Days Resume
- Contributes to the development of, and the review and revision of policies and procedures for UM Standards and Compliance Dept
- Contributes to the development of, and the review and revision of, CM Programs and Annual Reviews
- Development and maintenance of job descriptions, performance standards, and performance evaluations for all staff within Case Management. This includes: Medical Case Manager; Disease Manager; Transplant Case Manager; Benefit Specialist; Case Management Referral; Supervisor; Case Mgt/Onsite Review/Discharge Planner (C.O.D.)
- Development of career paths and incentives (financial and other reward types) for staff including oversight of Supervisors to ensure appropriate advancement and rewards for staff
- Overall responsibility for productivity and quality performance within department. Directly responsible the implementation of divisional initiatives and projects
- Serves as content specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation
- Develops staff schedule and revises assignments daily to assure optimal unit coverage and distribution of workload within staffing standards. Covers on units as needed and serves as a resource for complex case management issues
6
Responsibilities For VP, Senior Manager Case Management Resume
- Manages the daily operations of the assigned case management team to meet department objectives of determining medical necessity of admissions, coordination of appropriate plans of care, discharge planning, documentation, referrals, and care facilitation
- Understands, applies, and supports department and hospital policies, procedures and standards
- Demonstrates effective customer relations skills, promotes a positive work environment and contributes to the overall team effort. Establishes good working relationships with physicians, clients and other members of the health care team
- Actively participates in and promotes Methodist Le Bonheur Healthcare’s commitment to Quality Improvement efforts; identifies and communicates areas for improvement in ongoing efforts for quality care; assists in gathering, analyzing and presenting data as assigned
- The Associate is required to have visual acuity to operate motor vehicles
- Develops policies, and processes to ensure compliance of all MWMC payors, Joint Commission standards, and Tenet utilization and discharge planning policies and regulations
- Is responsible for all department day to day operations
- Develops and maintains process for ensuring reimbursement for inpatient and observation level care. Is responsible for upfront denial prevention. Communicates all cases to be appealed denied cases as appropriate
- Has direct report responsibilities for, Case Managers, Discharge planners and administrative staff
7
Responsibilities For Manager, Case Management Resume
- Manage personnel actions including, but not limited to individual supervision, hiring, orientation, performance appraisals, promotions and scheduling; and counsel and conduct formal discipline of staff
- Collects and provides utilization data to the Medical Staff, Nursing and Administration
- Maintains relationship with all payers, and outside agencies
- Supervise the daily activities of the RN Case Managers and the Clinical Administrative Supervisor
- Monitors the activity of the assigned case management units to assure compliance with policies, procedures and WC Laws and regulations specific to the State where the account is doing business
- Monitors quality of care and case management activities through the use of audits and evaluations
- Attends client specific required meetings
- Make sure as policies and procedures change that client compliance and reference books are updated
8
Responsibilities For Manager Case Management Resume
- If UR Labor Codes or Regulations in CA change, update UR plans and letters as necessary. This would also be the same for any NV accounts if Nevada Statues or Administrative Regulations would change
- Acts as liaison for providers, injured workers, and employers’, external and internal staff
- Interviews, hires, schedules, assigns work to, evaluates, disciplines, and when necessary, recommends discharge of departmental personnel. Completes timely performance appraisals. Ensures compliance with departmental and organizational policies and procedures
- Assists the Director with overseeing all quality assessment and improvement activities, including preparing the required reports for submission to the Quality Assessment Department
- Participates in all departmental planning activities aimed at accomplishing short and long-term goals
9
Responsibilities For Manager / Case Management Resume
- Assists the Director with University collaborations and other joint ventures
- Develops programs to track and analyze case management data collection process. Analyzes data to identify patterns and trends of performance. Addresses process performance issues that negatively affect outcomes
- Develops programs to track and analyze case management data. Provides timely, relevant, and accurate summary reports to medical staff, nursing, ancillary services, and administration
- Provides supervision and education for social work students interning at HFH
- Masters Social Work (MSW) is the education requirement
- Manage the case management program and team through monitoring and review of members within each risk level according to stratification criteria, scoring, clinical judgment, and triggers identified by the case manager
10
Responsibilities For Manager, Case Management, Sacramento Resume
- Assess and evaluate case management team through monitoring and reviewing documentation of care plan effectiveness, success of interventions, identification of variances, and progress to goal. Provide coaching and/or training in areas requiring improvement
- Ensure members are receiving appropriate and timely access to quality care through case management program
- Oversight and management of case manager case load to ensure team is adequately resourced to provide regular outreach and conduct case management activities
- Lead collaborative efforts to develop processes and protocols with Managed Care Organizations that are designed to promote care continuity and bridge the gap between medical and dental health of members
- Interpret and communicate metrics designed to evaluate case management program and if necessary develop action plans to address gaps and/or deficiencies
- Case management experience and recent nursing experience in an acute care setting particularly in medical/surgical, pediatrics, or obstetrics and management experience
Related to Manager, Case Management Resume Samples
Case Management Resume Sample
Work Experience
• Work closely with Client Management Sector Heads and GBM Banking Coverage teams to understand volumes and types of requests incoming to Case Management team
• Manage the capacity of the Case Management team and ensure timely execution of all incoming tasks to the queue, using tracking provided by t...
Professional Skills
• Critical thinking skills, effective writte...
• Excellent written and verbal communication...
• Strong and influential face to face and wr...
Manager, Portfolio Management Resume Sample
Work Experience
• Three to five years of experience in media planning, including two to three years’ supervisory experience
• Presents plans to day-to-day clients as well as clients’ retail and food service stakeholders
• Identify and evaluate new business opportunities for senior management, ...
Professional Skills
• Proven leadership skills; ability to drive...
• Proven experience influencing, aligning an...
• Professional Manager level experience in a...
Manager, Workforce Management Resume Sample
Work Experience
• Manages and is responsible for the successful achievement of service levels for assigned programs while minimizing costs
• Manages and develops assigned technical and administrative staff, including subordinate supervisors, and performs personnel actions including hiring and performance evaluation
...
Professional Skills
• Brings strong problem solving skills, anal...
• Strong business acumen & analytical skills...
• Demonstrated team building and leadership ...
Servicing Manager Resume Sample
Work Experience
• Experience in the asset management industry
• Good product knowledge in multi-asset class
• Mature, strong communication skills and detailed-oriented
• Leading a team to ensure the timeliness and accuracy of Corporate Action and Dividend Payments to Cit...
Professional Skills
• Proven Leadership and Employee Management ...
• Proven Leadership and Employee Management ...
• Strong focus on Client service/experience ...
Manager, Enterprise Resume Sample
Work Experience
• Thorough knowledge of the bank’s PMO methodologies and project lifecycle stages
• Three to five years’ experience in leading the Implementation, enhancements, and support of Concur in a large scale enterprise-wide regulated environment. This includes
• Development of business...
Professional Skills
• Proven leadership skills with the manageri...
• Strong communication and interpersonal ski...
• Communicate effectively and presentation s...
Mgr Capture Management Resume Sample
Work Experience
• Lead/Support Raytheon’s business proposal activities
• Leadership experience as an international capture/BD Lead for pursuits with experience in successful business captures in the airborne ISR market
• Direct experience in successfully working with systems controlled under t...
Professional Skills
• Experience with customer focused marketing...
• Demonstrated experience leading capture ac...
• Strategic planning and demonstrated relate...