Manager/Director, Case Management
NAMM North America Medical Management - Ontario, CA

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Provide leadership and administrative oversight of Care Coordination and general case management. Develop strategies and programs to meet the needs of the companies goals and obejctives.

  • Conduct needs assessment including: development of methods for determining potential patient enrollment, medical literature review, analysis of pre-program utilization and costs
  • Develop enrollment methods including correspondence to members, PCPs and physician champions
  • Develop clinical practice guidelines
  • Evaluate and enhance electronic systems for tracking membership and outcomes
  • Develop Clinical Education Modules
  • Develop tools to assist nurses with clinical assessment and intervention (glossary of terms, clinical algorithms, medication references)
  • Develop tools to assist nurses with patient education
  • Identify areas where pharmaceutical support may be appropriateDevelop and organize clinical education training and program launch training
  • Identify measurable productivity areas and monitor productivity and efficiency
  • Provide clinical support to statewide staff
  • Develop and organize marketing to physician office staff
  • Meet with community resources to develop collaboration and referral processes
  • Meet with Market specific leadership for new implementation of program as needed.

  • MSN/MS preferred
  • BSN required or equivalent experience in Case Management in a management position, preferably in a managed care environment
  • Graduate of an accredited school of nursing
  • Current California R.N. License
  • Valid California Drivers License and insurance
  • Will require some travel between locations within a 1 mile to 80 mile radius 1 to 2 days a week




NAMM North America Medical Management - 14 months ago - save job