MMS Group

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Job Details:

Job Overview:
Job Title: Manager, Integrated Care
Employer: MMS Group
Location: Milwaukee, Wisconsin
Job Type: Full-Time
Profession: Registered Nurse
Career Level: Experienced
Experience: 3-5 years
Education Level: Bachelor’s Degree
Travel: none

Job Description:
Manager, Integrated Medical Management -Milwaukee
Provide leadership for experienced clinical team with a strong focus on mental/behavioral health issues.

Lead Case Management and Care Coordination services and activities for members with co occurring behavioral health and medical conditions. The clinical team will include licensed medical and behavioral health clinicians.

Manage clinical services including oversight of clinical policies and procedures and daily activities of integrated care coordination team staff.
Ensure adequate staffing to conduct case management activities and effectively distribute workloads.
Ensure team members receive appropriate training to serve the population and demonstrate effective engagement activities for individuals with various disabilities including chronic physical and behavioral health conditions.
Ensure Integrated Clinical Services staff are trained on NCQA and HEDIS measures and processes to ensure compliance.
Ensure all programs and clinical operations are in full compliance with state and federal regulations, including HIPAA.
Ensure compliance with plan’s emergency management policies, procedures and processes by acting as liaison with other business units.
Monitor the effectiveness of existing procedures and outreach/intervention efforts in demonstrating positive outcomes for members.
Ensure appropriate case planning, education and interventions are conducted for members defined to be at risk.
Ensure staff coordinate exchange of information between behavioral health and medical providers in developing comprehensive care plans for at-risk members.
Monitor data to address quality measures, trends or potential improvement opportunities including provider issues, service gaps and member needs.

Job Requirements:

Bachelor’s degree in Behavioral Health or related field 
Licensed clinician – Psych RN, or LCSW, LMFT
Managed Care Experience required
3+ years case and/or utilization management experience.
Substance Abuse and Chronically Mentally Ill Community Resources experience helpful

Preferred : Case Management Certification NCQA and Accreditation Experience

Thorough knowledge in assessment, diagnosis, treatment of individuals with serious mental health or substance abuse disorders, case management, mental health community resources and local health delivery systems. 
Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.

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About MMS Group:
MMS is a Managed Care executive search firm. We are Managed Care’s complete recruiting resource.

Click Here for Details and to Apply

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